The Determinants and Outcomes of Absence Behavior : A Systematic Literature Review

This research aims to identify and analyze the frequency of the researched determinants and outcomes of absenteeism and thus create an extensive pool of knowledge that can be used for further research. A systematic review, based on Tranfield, Denyer, and Smart’s guidelines of 2003, was used. An electronic search of the Scopus database led to the inclusion of 388 peer-reviewed research articles. Finally, 100 top-quality articles were analyzed using content analysis. This article provides several starting points for practitioners and researchers when investigating absenteeism and its potential determinants and outcomes. It also shows that there is an evident imbalance between empirical research dealing with determinants and research dealing with absenteeism outcomes. Employee attitudes stand out among the most repetitive absenteeism causes, while turnover, organizational health, and loss of productivity are some of the most researched absenteeism outcomes. Most research takes place in the manufacturing industries, followed by hospitals and other public service organizations, banks, and insurance companies. This systematic literature review is the first known attempt of this kind of review of the causes and consequences of absence behavior. It covers a wide range of literature published from 1969 until today and includes more than 150 different absenteeism determinants and outcomes.


Introduction
The human element plays a significant role in any organization.Employees and human resource management are key determinants of service quality, customer satisfaction and loyalty, competitive advantage, organizational performance, and business success (Bitner et al. 1990;Nickson et al. 2002;Schneider et al. 2003).Many theories, models, and empirical studies in the management literature that underline the crucial role of human resources for organizations support this belief.
One of the most important issues that human resource managers are dealing with is managing their staff's absence behavior, i.e., absenteeism.Absenteeism is a temporary absence from work (temporary withdrawal from an organization) for reasons such as illness, death in the family, or other personal issues (Mathis and Jackson 2004).It is also interpreted as an employee's intentional or habitual absence from work (Cucchiella et al. 2014).According to the literature, there are several types of absenteeism.The most common type is sick leave (Duff et al. 2015;Løkke et al. 2006;Pizam and Thornburg 2000), while some authors consider vacation, maternity leave, military duty, education absence, etc. as forms of absenteeism, too.Some authors differentiate involuntary absenteeism (e.g., certified sickness, funeral attendance) and voluntary absenteeism (e.g., vacation, uncertified sickness) (March and Simon 1958).(Gibson 1966;Johns 1978) distinguish between authorized and unauthorized absenteeism, while (Blau 1985) and (Cheloha and Farr 1980) divide absenteeism into organizationally excused and organizationally unexcused categories, with types such as sickness, jury duty, religious holidays, funeral leave, and transportation problems belonging to the category of excused forms of absence.Absenteeism is relatively easy to measure.There are two kinds of absence metrics: time lost and absence frequency.Time-lost measures express absenteeism as a sum of units of time (e.g., hours or days) away from work (Steel 2003), while absence frequency is the number of absences in a specific period of time regardless of duration (Chadwick-Jones et al. 1971).
Excessive absenteeism can have a serious impact on any company.The seriousness of this impact is the subject of extensive debate.Some of the negative consequences of absenteeism are high costs, such as direct compensation costs or replacement costs, as well as loss of productivity (Mathis and Jackson 2004).The importance of studying absenteeism lies in the fact that a better understanding of absence behavior can lead to its successful management.
To address this issue, the aim of this study is to identify, summarize, and analyze the antecedents and consequences of absenteeism, as well as their relation to absenteeism itself, in the largest database of peer-reviewed literature-Scopus-using a systematic review methodology.This is the first known attempt of a systematic review of the aforementioned subject.A total of 388 articles were reviewed.Accordingly, three research questions were formulated.
RQ1.What are the most researched determinants and outcomes of accruing employee absence behavior?RQ 2. How do the related determinants influence absence behavior?RQ 3. What kind of impact can absenteeism have on related outcomes?
The aim of the first research question is to identify the determinants and outcomes of incurring absenteeism as reported in the literature and highlight the most repetitive.The second research question aims to identify a positive or a negative impact of related determinants on absenteeism, while the third research question intends to identify a positive or a negative impact of absenteeism on related outcomes.
The next section gives an overview of the existing literature reviews on absenteeism determinants and/or outcomes.Section 3 explains the systematic review methodology used in this study, with all the inclusion and exclusion criteria.Section 4 summarizes the main results of the study.This is followed by a discussion section, including recommendations for further research.Finally, the conclusions of the study and limitations of this research are presented in Section 6.

Theoretical Background
Absence behavior has been intensively researched for more than five decades.The first significant papers on the systematization of absenteeism causes and consequences date back to the 1970s.The approaches to the classification of factors that influence absence behavior, as well as the consequences of absenteeism, differ from one author to another.This chapter offers a short overview of the most significant authors and their review papers which deal with the determinants and outcomes of absenteeism.
In the 1970s, (Muchinsky 1977) conducted a narrative review of the relationship between absenteeism and personal, attitudinal, and organizational variables.Other than these absenteeism determinants, he researched the relationship between absenteeism and turnover, which represent two of the most important withdrawal behaviors in any organization.Muchinsky also examined absenteeism from several perspectives, including the psychometric problems of measurement, as well as efforts to deal with this phenomenon at a very practical level, including possible solutions for the reduction of employee absenteeism.(Rhodes and Steers 1981) developed an all-inclusive model of absenteeism that consisted of 8 factor groups which have a possible effect on employee absenteeism: Job situation, Personal characteristics, Pressures to attend, Job satisfaction, Employee Values and Job Expectations, Attendance Motivation, Ability to Attend, and finally, Employee Attendance.
While Muchinsky and Rhodes and Steers mostly dealt with absenteeism determinants, (Goodman and Atkin 1984) went a step further and tried to identify what effect absenteeism has on different population levels: the individual worker, adjacent workers, the work group, the organization, other social organizations, and society.Among the negative consequences, they pointed out a loss of rewards, disciplinary action, accidents, greater work stress, lower productivity, and higher costs as most important.
In 1985, (Durand 1985) selected several antecedents and consequences of absenteeism and reviewed absenteeism from two perspectives: industrial-organizational psychology and organizational behavior management.His research was focused on influences that are potentially amenable to change.He found that work unit size, worker responsibility, and organizational scheduling are three potential antecedent influences that could be used to improve employee attendance, and that feedback, rewards, and punishments were shown to be effective attendance control procedures.
In the late 1990s, (Harrison and Martocchio 1998) introduced a new time variable in their research of absenteeism causes and its consequences.They used a time-based system to organize and analyze the causes and consequences of absenteeism in the form of a literature review.In that context, they defined personality and demographic characteristics (gender, age, depression, smoking, heavy drinking, drug abuse, and exercise) as long-term causes of absenteeism.Job-related attitudes and social context represented the mid-term group.Variables belonging to this group, such as high levels of job satisfaction, job involvement, organizational commitment, doing meaningful tasks, working in a group or a culture with strict attendance norms, working in a non-union environment (with less paid sick leave), working on the day shift, and working in an organization with flexible scheduling, all contributed to lower absenteeism.Finally, decision-making mechanisms, such as an employee's intentions regarding attendance, belong to a group of short-term causes.
Furthermore, Harrison and Martocchio indicated some variables that affect absenteeism in a positive way.A person who works under attendance incentives, who can somehow avoid acute stressors such as infections, injuries, and injustices, who can discount the utility of non-work behaviors, who enjoys attending work, and who feels social pressure to attend work with no impediments to do so will have lower absenteeism rates.
In the last 10 years, a systematic literature review methodology was applied on two absenteeism-associated studies (Daouk-Öyry et al. 2014;Davey et al. 2009).Both studies were conducted in a hospital setting.
Daouk-Öyry et al. used the PubMed and CINAHL Plus databases, using articles published between 2007 and 2013 in order to examine the antecedent and outcome variables that concern both turnover and absence behavior.In their research, they proposed a multilevel conceptual model called JOINT (Job, Organization, Individual, National and inTerpersonal factors) for the future investigation of absenteeism and turnover among nurses.
The second group of authors (Davey et al. 2009) used a more comprehensive scope of databases (10 of them, including SCOPUS) and a longer period of time .The objective of their research was to identify individual and organizational predictors of the short-term absences of staff nurses reported in the research literature.They reported that the lack of theory about nursing absenteeism was the reason for the inconsistent results found in their review.
Despite of this rather intensive research on the topic in the form of reviews, the characteristics of past research both leave and open up space for new approaches.The existing review papers dealing with absenteeism causes and consequences are mostly of the narrative type.On the other hand, the methodology approach used in this paper-a systematic review-is relatively new and has not been used so far within the area of economics and management, which is a strongly under-research area in this sense.Moreover, a research review for a period of almost 50 years represents one of the additional values of this paper.

Methodology
Systematic reviews help to develop a reliable knowledge base for future research in different fields of science.At first, the systematic review was used only in the medical sciences.In 2003, Tranfield, Denyer, and Smart adjusted the methodology of the systematic review to the management field.Unlike the traditional literature review, a systematic review improves the quality of the review process and outcomes by employing a transparent and reproducible procedure (Tranfield et al. 2003).In order to produce a quality review, scientists should respect the distinct and exacting principles of transparency, inclusivity, explanation, and heurism (Denyer and Tranfield 2009).According to (Tranfield et al. 2003), a systematic review consists of three steps: (1) a detailed a priori planning of the review, including a precise definition of the aim and research question to be approached in the course of the review; (2) a rigorous execution of the review itself comprising the identification of relevant literature using explicit, reproducible criteria for inclusion and exclusion, which is supported by an appraisal of the quality of the reviewed studies and the strength of their findings; and (3) the reporting and dissemination of the review results.The introductory section explains the aim, the objectives of this review, as well as the research questions (step 1).The selection of the relevant literature (step 2) is presented in the methodological section, while the third step-a synthesis and analytic review of the selected articles and a comprehensive presentation of the results-is presented in the results section.
For the purpose of this study, the Scopus database was chosen as the most relevant source because it is the largest database of peer-reviewed literature.First, a complex keyword search of titles, abstracts and keywords was performed in order to identify studies that focus on the determinants and outcomes of absence behavior.The initial search of the database was undertaken using basic keywords and basic Boolean operators for synonyms: "antecedents" (OR causes, OR determinants, OR predictors), "consequences" (OR outcomes), and "absenteeism" (OR absence behavior).Second, the search was confined to document type: article; -language: English; -subject area: "Business, Management and Accounting" and "Economics, Econometrics and Finance." When these criteria were applied, the initial sample resulted in 388 papers in the period from 1969 to 2018 (26 March).
After the analysis of abstracts and full texts, this sample was narrowed to 124 of the most relevant articles.Articles that refer to school absenteeism, theoretical articles, reviews, and meta-analysis were excluded from further analysis.
The last step was the selection of the best-quality articles.Since paper citations serve as a de facto vote on a given article's contribution towards knowledge accumulation and development (Saha et al. 2003), the first 100 articles were selected for the next step.

Results
This section presents the results of the analysis of the chosen articles.A synthesis of the data started with an analysis of the key design characteristics of each study and the operationalization of the variables involved.
The majority of the selected articles was published over the past 18 years.The distribution of articles by decade was as follows: 1960-1969: 1 article; 1970-1979: 4 articles; 1980-1989: 10 articles; 1990-1999: 27 articles; 2000-2009: 30 articles; 2010-2018: 28 articles.All 100 articles contain empirical research supported by primary or secondary data.When it comes to study design, both experimental and observational study designs are included.Most of the selected studies used a cross-sectional design (70), 22 of them relied on longitudinal design, 5 were designed as quasi-experimental, and 3 used a mixed-method design.
Data for these studies were collected using different methods.The majority of these studies, 43 of them, used survey questionnaires and organizational databases in combination as their method for data collection.Only databases were relied on in 32 studies, while solely survey questionnaires were used in 20 studies.Other combinations of data collection were also used: database, interview and focus group (1), interview and focus group (1), and interview and survey questionnaire (3).
The majority of the studies was conducted on an individual level and the population consisted of employees.Most research took place among hospital staff, along with manufacturing, government, and bank employees.
The main geographical source of these empirical studies is the United States of America (38 studies), followed by Canada (9) and Australia (8).Three studies among the selected 100 were conducted among a group of countries.
Most of the 100 articles tested multiple variables of either the causes or consequences of absenteeism.85 articles only tested antecedents, 8 only tested consequences, and 7 tested both.For a comprehensive view, in Section 4.1 absenteeism determinants and the impact of related determinant on absence behavior are described.The positive and negative outcomes of absenteeism are described in Section 4.2.Afterwards, Table 1 presents the summarized results.The table comprises data about the authors sorted into alphabetic order, the year in which each article was published, the article title, study design, study population, citations, types of absenteeism determinant and outcome, and the relation of the article with absenteeism (positive or negative).A negative mark (−) after a related determinant means that the presence of that determinant decreases absenteeism rates.A positive mark (+) means that absenteeism rates are higher if that determinant is present or its value is growing.When it comes to outcomes, a negative mark means that the higher absenteeism, the lower the outcome rates.A positive mark by the outcome stands for an increase in an outcome correlated with the value of absenteeism.

Determinants of Absenteeism
For the purpose of this article, absence behavior determinants are divided into several categories according to their type: personal, demographic, attitudinal, health-related, organizational, and job determinants.
Among personal factors, conscientiousness, agreeableness and neuroticism are some commonly explored causes of absenteeism (Kolz 1999;Hattrup et al. 1998;Störmer and Fahr 2013).While conscientious and agreeable employees seem to be less absent from work, neuroticism has a positive effect on absence behavior.
Several studies explore age, gender, marital status, the presence of children, race, and ethnicity.While (Garcia 1987) found that age has a positive relationship with absenteeism, (Gellatly 1995), (Gerstenfeld 1969), (Løkke Nielsen 2008), and (Redman et al. 2011) have shown that younger workers are more absent than older ones.Since gender is an important explanatory variable in most absenteeism studies, it is included as an independent variable in all analyses.However, (Vistnes 1997) observed gender as a dependent variable and found that there are some notable differences between the absence behavior of men and women.This study shows a positive correlation between the number of children under the age of six and the likelihood of absence among women.In addition, employees with greater family and personal obligations have a higher frequency of absenteeism (Deery et al. 1995).Married employees are more absent than single ones, and employees belonging to racial or ethnic minorities are absent from work more than their non-minority colleagues (Garcia 1987).
Many authors study attitudes as important determinants of absenteeism in organizations.Job involvement and organizational commitment in interaction show a negative correlation with absence behavior (Blau 1986).The literature on absenteeism suggests that employees might choose to withdraw from an aversive work situation as this makes them dissatisfied.Therefore, it is no surprise that job satisfaction is one of the most researched attitudes (Boon et al. 2014;Yang 2010;Ybema et al. 2010;Cohen and Golan 2007;Steel et al. 2007;Kristensen et al. 2006;Vanden Heuvel 1997;Zaccaro et al. 1991;Rosse and Hulin 1985;Garrison and Muchinsky 1977).In addition, (Wegge et al. 2007) showed that in employees with low job satisfaction the impact of job involvement on absence behavior is much more pronounced than in employees with high job satisfaction.Among the health factors that influence an employee's absence behavior, stress seems to be the most important one (Zeytinoglu et al. 2004;Kim and Garman 2003;Iverson et al. 1998).
Research shows that there is a relationship between absenteeism and many organizational and job characteristics.When it comes to firm size, larger firms seem to have higher absence rates (Scoppa 2010).Even when mediated with wages, this difference is bigger (Winkelmann 1999).Self-employed workers are less absent than workers employed by others; public workers are more absent than private workers; workers on a temporary contract are less absent than workers who have a permanent contract (Scoppa 2010).Employees with a five-day work week have smaller absence rates than employees who work four days a week (Barmby et al. 2001).Shift-turn (mornings, afternoons, and nights), days of the week (Sunday to Saturday), and position in the shift cycle (start, middle, and end cycle) also affect absenteeism (Nicholson et al. 1978).
Absence controls can have a significant effect on absence behavior (Kopelman and Schneller 1981).Improving an absence policy by introducing a punishment and reward system in the organization will reduce casual absences but also increase Family and Medical Leave Act (FMLA) absences (Johnson et al. 2014).The FMLA covers an absence caused by the birth of a child, care for a newborn or adopted child, care for an employee's spouse, child, or parent who has a serious health condition, etc.

Outcomes of Absenteeism
Absenteeism lowers process quality and output (Morrow et al. 1999) as well as a firm's operational efficiency (Kopelman and Schneller 1981).
Absenteeism affects other withdrawal behaviors, such as turnover.Some articles show a strong positive relationship between absenteeism and turnover (Morrow et al. 1999;Farrell and Petersen 1984;Waters and Roach 1979), while the data from (Parasuraman 1982) indicate a lagged effect between prior absenteeism and turnover.
Besides the above, the presence of absence behavior seems to aggravate overall organizational health; employees in such organizations have lower morale, high levels of stress, poor communication, and the relationships between management and staff are poor (Mchugh 2002).
Additionally, absenteeism has a negative impact on organization productivity (Herrmann and Rockoff 2012;Jung and Takeuchi 2010).The expected loss in daily productivity from employing a temporary substitute is on par with replacing a regular worker of average productivity with one at the 10th-20th percentile of productivity (Herrmann and Rockoff 2012).

Discussion
In accordance with previous research, this literature review shows that absenteeism can be caused by many personal, demographic, attitudinal, health-related, organizational, and job determinants.When considering the time dimension as defined by (Harrison and Martocchio 1998), most of the studies are dealing with long-term and mid-term causes of absenteeism, such as gender, age, family obligations and job-related attitudes.
In relation to the research questions, this literature review shows that what stand out the most as the most repetitive absenteeism causes are job satisfaction (18 times), organizational commitment (11), age (7), pay satisfaction (5), job involvement (3), and wages (3).Out of these six most-mentioned causes of absenteeism, four of them (job satisfaction, organizational commitment, pay satisfaction, and job involvement) belong to employees' attitudes.This is not a surprise since employees' attitudes in general represent one of the most researched topics of organizational behavior in general as well.This indicates that an additional, separate literature review could be performed focusing solely (separately) on employees' attitudes as predictors of absenteeism.
This research also showed that there is an evident misbalance between empirical research dealing with absenteeism determinants and research dealing with its outcomes.In the majority of research, absenteeism outcomes have negative implications: e.g., absence behavior lowers productivity, satisfaction, organizational health, outputs, and quality, while it increases turnover and costs, which is in line with (Goodman and Atkin 1984) conclusions.The measurement and management of absenteeism outcomes are issues of exceptional importance for every organization, not only in regard to additional costs, incurred either for the employer or for society (systems of social/health insurance, i.e., sickness benefits), but also in regard to an organization's development and sustainability.
The distribution of the publishing times of articles selected for this research, i.e., the fact that two-thirds of the analyzed articles were published in the last 20 years, shows that interest in this topic is constantly growing.The analysis also indicates a disparity in the number of articles and the industries in which this research takes place: most research deals with absenteeism in manufacturing industries, followed by hospitals and public service organizations, and then banks and insurance companies.On the other hand, some industries are strongly under-researched (e.g., tourism or the hospitality industry).This surely opens up a potentially interesting research area where it is to be expected that, due to its high labor intensity, the connections between absenteeism behavior and its causes and consequences would be easier to detect and measure.

Conclusions
Absenteeism is a crucial issue for human resource management.The understanding of absence behavior starts with an understanding of its determinants and outcomes.This article summarizes some of the possible causes and consequences of absenteeism as found in the articles of the Scopus database for a 49-year period by using the methodology of a systematic literature review.This kind of approach to the literature review has enabled the creation of an accessible pool of knowledge about the determinants and outcomes of absence behavior.It is important to emphasize that this research can be easily replicated because it followed the principles of transparency, inclusivity, explanation, and heurism.
Even though this article provides several starting points for practitioners and researchers when investigating absenteeism and its determinants and outcomes, it is not exempt from limitations: it is limited to the Scopus database, empirical evidence, and the English language.A further extension, including other databases, a review of meta-analyses and/or reviews, as well as articles in other languages, would provide interesting areas for future research.
Source: the authors' research.