Article Text

Download PDFPDF

Original article
Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees
  1. Johan Høy Jensen1,
  2. Esben Meulengracht Flachs1,
  3. Janne Skakon2,
  4. Naja Hulvej Rod3,
  5. Jens Peter Bonde1
  1. 1 Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
  2. 2 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  3. 3 Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Johan Høy Jensen, Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen DK-2400, Denmark; johan.hoey.jensen{at}


Objectives We investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees.

Methods The study population comprised employees from the Capital Region of Denmark (n=14 388). Data on reorganisation at the work-unit level (merger, demerger, relocation, change of management, employee layoff or budget cut) between July and December 2013 were obtained via surveys distributed to the managers of each work unit. Individual-level data on work-unit exit, total and long-term sickness absence (≥29 days) in 2014 were obtained from company registries. For exposure to any, each type or number of reorganisations (1, 2 or ≥3), the HRs and 95% CIs for subsequent work-unit exit were estimated by Cox regression, and the risk for total and long-term sickness absence were estimated by zero-inflated Poisson regression.

Results Reorganisation was associated with subsequent work-unit exit (HR 1.10, 95% CI 1.01 to 1.19) in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes (HR 1.52, 95% CI 1.30 to 1.79), merger (HR 1.29, 95% CI 1.12 to 1.49), demerger (HR 1.41, 95% CI 1.16 to 1.71) or change of management (HR 1.24, 95% CI 1.11 to 1.38). Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence (OR 1.15, 95% CI 1.00 to 1.33), which was particularly important for merger (OR 1.31, 95% CI 1.00 to 1.72) and employee layoff (OR 1.31, 95% CI 1.08 to 1.59).

Conclusions Specific types of reorganisation seem to have a dual impact on subsequent work-unit exit and sickness absence in the year after change.

  • sickness absence
  • organizational change
  • reorganization
  • health care workers
  • turnover

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors JHJ had full access to all data provided in the present study and takes responsibility for the integrity and the accuracy of the data analyses. All authors were responsible for the current study design. JHJ wrote the initial draft of the manuscript. All authors contributed to the present study and approved the final draft of the manuscript.

  • Funding The study was funded by The Danish Working Environment Research Fund (project number: 13-2015-03).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The Regional Ethics Committees of the Capital Region stated that ethical approval was not required for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.