The effects of paid sick leave on worker absenteeism and health care utilization

Abstract

We estimate the short-term effects of paid sick leave on worker absenteeism and health care utilization in the United States using data from the 2000-2013 Medical Expenditure Panel Survey. We use both parametric and matchingbased difference-indifferences methods to account for nonrandom selection into jobs that offer paid sick leave and estimate the treatment effect separately for workers who gained and lost sick leave benefits. We find consistent evidence of increased absenteeism among female workers who gained paid sick leave but not for other groups. Estimates for office-based visits are mostly statistically insignificant and may not have a causal interpretation due to preexisting trends.

Paid sick leave policy impacts on health and care utilization in the United States: why policy design matters

“…Workers without paid sick leave are more likely to work while sick, which can increase contagion and lead to poor health outcomes [14,15]. Lack of paid sick leave also means workers are less likely to go to the doctor for illness or routine health appointments, which can lead to workers taking more time off in the long run [16,17]. Paid sick leave policies have the potential to reduce contagion work, but only if workers are able to access and use paid leave.…”

Is paid sick leave bad for business? A systematic review

“…22,27,31,34,36,45,49 A recent study by Chen and colleagues found only females, but not other groups, who gained PSL reported a small (22%), but significant increase in work absences. 22 Zimmer found those with PSL worked fewer hours when faced with a priority condition with doctorrecommended treatment, but not in the case of a nonwork injury with doctor-recommended treatment or poor health. 31 The rest of the studies reporting increased absences from work among employees offered PSL also found decreases in presenteeism and were reported in that section.…”

“…22,31,36,49 Ten studies investigating absence from work found that PSL increased worker absence, 22,23,29,[31][32][33]36,37,49,53 one reported fewer overall absences in the workplace, 12 and seven did not establish a significant relationship between PSL and worker absence. 22,27,31,34,36,45,49 A recent study by Chen and colleagues found only females, but not other groups, who gained PSL reported a small (22%), but significant increase in work absences. 22 Zimmer found those with PSL worked fewer hours when faced with a priority condition with doctorrecommended treatment, but not in the case of a nonwork injury with doctor-recommended treatment or poor health.…”

“…Table 1 includes the article characteristics including study design, data source, population, setting, unit of analysis, and whether or not the paper substantively focused on legally mandated PSL. Thirteen studies were quasi-experimental in nature, 12,[18][19][20][21][22][23][24][25][26][27][28][29] generally utilizing a difference-in-differences approach. The remaining studies were observational in nature, many using panel and longitudinal data for analysis.…”

“…The remaining studies were observational in nature, many using panel and longitudinal data for analysis. The most common data sources were the Medical Expenditure Panel Survey (MEPS) 22,[30][31][32][33][34] and Census sources including the Current Population Survey (CPS), 12,26 Bureau of Labor Statistics (BLS), 24,35 and American Time Use Survey (ATUS). 15,36 Additional data sources include the National Health Interview Survey (NHIS), 27,[37][38][39] National Core Indicators (NCI), 40,41 the Centers for Disease Control (CDC), 16,21,42 and The Shift Project.…”