Browsing by Subject "Arbeitszeit"

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Arbeitszeitmodelle im Schweizer Gesundheitswesen : qualitative Untersuchung in der Maximalversorgung
(2023) Linggi, Michael; Ernst, Christian
Research into the working time models of physicians is of great importance to ensure the health and safety of patients, to improve the well-being and satisfaction of medical staff, to increase the efficiency of work processes and to counteract the shortage of labor. The dissertation discusses the different working time models in the Swiss health care system, especially in the field of maximum care. It shows the working time models applied in practice as well as the challenges arising from their implemen-tation. It concentrates on the field of surgery (cutting discipline), but is not limited to specific surgical specialties, but follows a generalist approach. The aim of the re-search is to show which working time models function in the complex daily work of physicians in the Swiss model of maximum care and to what extent they can be transferred to other levels of care and countries. Due to the complexity of the topic, the research question was answered with the help of qualitative interviews. Both phy-sicians and administrative staff were interviewed. By means of qualitative content analysis, the various categories were then formed in order to be able to classify the transcribed text passages. The dissertation is based on the results of current research, for which primarily the contributions of generalist research were used. It has been shown that the organiza-tion of working time has a considerable influence on the satisfaction and health of employees. In particular, 24-hour operations and the associated shift patterns play an important role. Theoretical approaches to human, social and psychological capital al-so illustrate why employees are one of a companys most important resources. This forms the basis for the presentation of different working time models and the identifi-cation of influencing factors. Future-oriented aspects are also taken into account, such as the possibility of using robots in surgery to perform various procedures, which opens up additional options for designing new working time models. The findings of the dissertation can be summarized as follows: It is important to con-sider working time models in a global context, as the topic is very complex and multi-factorial. Basically, three levels can be identified that have to be considered when de-veloping innovative working time models: Society, institution and individual. In order to make new working time models possible, structural, societal prerequisites such as the Working Time Act and family-friendly framework conditions are needed. In addition, the institution, i.e. the hospital, must have the courage to break new ground and give employees the opportunity to work in new working time models. Finally, it is also up to the physicians to take personal responsibility and not take advantage of the employer. In addition to this overall approach with the three levels, the following focal points could be derived: Everyday work, work-life balance, research, education and training, career, work content, digitalization and other focal points. These focal points show which topics must be taken into account when developing new working time models. Finally, four working time models were identified as the most common: Part-time, Protected Time, Job Sharing and Home Office. In addition, labor legislation must cre-ate the framework conditions to enable these models to be used in a meaningful way. The findings are transferable to clinics and hospitals in other countries with a competi-tive health insurance system, such as Germany or Austria. This means that the find-ings and recommendations for improving working time models should also be appli-cable in similar legal and organizational contexts. This dissertation on the study of working time models among physicians at the high-est level of care provides an important basis for the further development of such models. The holistic view of the topic and the identification of challenges and focal points contribute to the improvement of future working time models. Hospital and clin-ic management should take these results into account when planning and implement-ing working time models. For future research, similar studies could be conducted in other countries.
Essays on health and nutrition in China
(2015) Nie, Peng; Sousa-Poza, Alfonso
This dissertation aims to investigate several major socio-economic determinants of health and nutrition in China. By using data from the China Health and Nutrition Survey (CHNS) spanning from 1991 to 2009, this enhances the understanding of the transition of health and nutrition with such unprecedented economic and social changes in China. This dissertation contains six chapters: more specifically, Chapter 1 gives a brief description of general background, research aim and also the outline. Then Chapter 2 examines the association between maternal employment and childhood obesity. Chapter 3 takes a comprehensive look at how income changes are related to calorie intake. Chapter 4 investigates the impacts of peers (one of most important aspects of social networks) on childhood and adolescent adiposity. Chapter 5 assesses the nexus between long work hours and health. Finally, Chapter 6 ends with some main conclusions and discussions. Chapter 2 analyses the alarming increase of overweight and obese children and considers the higher female employment participation in China. We analyze how maternal employment is correlated with childhood obesity in China. Our work makes a non-Western comparison in this field, which is useful as it is rather difficult to generalize the results (mostly significant positive association between maternal employment and childhood obesity) from related studies in the Western world. More importantly, we further explore how maternal employment is related to two key transmitters of obesity: diet and physical activities. We find no association of maternal employment and childhood adiposity. Moreover, maternal employment is also not associated with either diet or physical activity of children. However, our results are well consistent with some recent evidence in Europe (Greve, 2011; Gwozdz et al., 2013), supporting the evidence that maternal employment might not necessarily be detrimental to child adiposity. One tentative explanation is that, the major source of informal childcare in China is grandparents, who are more likely to provide childcare with a high quality. In Chapter 3, we provide an empirical analysis that looks at the association between income and calorie intake via a variety of parametric, nonparametric and semiparametric approaches. By means of panel data settings, we are capable of capturing time-invariant individual heterogeneity. It is worth noting that taking a close look at calorie-income elasticities is crucial and implicative of the effectiveness of income-mediated policies for food security in China. Our findings provide strong evidence that calorie-income elasticities are small, irrespective of using parametric, nonparametric, or semiparametric techniques. Furthermore, these elasticities remain small when taking nonlinearities into consideration, and also for sub-analysis for gender, individuals with differences in calorie intake or even impoverished households. Although calorie-income are small, our results are well in line with some prior studies (Bishop et al., 2010; Lu and Luhrmann, 2012; Shankar, 2010; Zhong et al., 2012), suggesting that households might be quite successful in maintaining calorie intake stable as income changes. Also note, despite the marked increase in income, the Chinese demand for better food quality, food diversity and food safety have amplified (Gale and Huang, 2007; Liu et al., 2013b), instead of an increased demand for calorie intakes. Chapter 4 takes a detailed look at how peer effects are associated with childhood and adolescent obesity in China. It expands the empirical work beyond the Western domain in light of different cultural backgrounds between individualistic and collective societies. Furthermore, it broadens the dominant front of adolescents and adults by analyzing children as well. Note that, understanding peer effects on childhood adiposity is of great significance primarily because, as emphasized by Dishion and Tipsord (2011), children’s consumption behaviors are influenced by their peers. More importantly, childhood adiposity could result in persistent adulthood overweight or obesity (Loh and Li, 2013). In addition, the use of self-perceived perceptions of body weight allows for an exploration of the relation between peer effects and individual perceptions of weight status, thereby providing insights into understanding pathways by which peer effects operate within a relatively broader environment. We provide further evidence that peer effects exist not only among adolescents, but also children, suggesting that the formation of health lifestyles associated with peers is important for young children. In addition, we find that the magnitudes of peer effects change greatly over the distribution of individual BMI and stronger effects are observable at the upper end than at the bottom or median. This finding implies that obese individuals are more vulnerable to peers. Furthermore, females are more susceptible compared to males, which mirrors some U.S studies among adolescents (see, for instance, Trogdon et al., 2008). More importantly, we find that community-level average peer BMI is associated with self-perceived bodyweight in adolescents, providing evidence that a higher average peer BMI is related to the probability of a self-assessed perception of overweigh, in particular, for adolescent girls. All in all, our results support the existence of peer effects on childhood and adolescent obesity, but the magnitudes fall within the broader range for the U.S. adolescent studies using similar specification to ours. Therefore, it implies that peer effects do not necessarily strengthen within a collectivistic society, like China, as in comparison to the counterparts of an individualistic society, like the U.S. In Chapter 5, we provide a comprehensive picture of how long work hours are related to health, using not only subjective but also objective measures. Also, it provides a valuable comparison with existing studies predominantly in the Western world. More importantly, it explores several potential mechanisms through which long work hours could impact upon one’s health. In particular, it investigates the relation between long work hours and specific lifestyles, such as sleep, diet (calorie and fat intakes, time spent food preparation and cooking), physical activities (sports participation and time spent on sedentary activities). Apart from a cross-sectional settings, it also adopts a panel analysis, which allows for controlling for unobserved individual heterogeneity. Because, to the best of our knowledge, the only three studies in China (Fritjers et al., 2009; Verité, 2004; Zhao, 2008) all investigate subjective measures of health via cross-sectional data. We reveal that working above 50 hours per week (31-40 hours per week as the comparison), increases the probability of suffering from high blood pressure, though the effects are relatively small. Also, self-evaluated health is poorer for individuals working long hours compared with those weekly working 31-40 hours, however the effect is not so strong. Eventually, long work hours have various impacts of different aspects of individual lifestyles. Specifically, we cannot find a positive correlation between long work hours and obesity. Nevertheless, long work hours seem to be related to a decreased fat intake and less time spent on sedentary activity like watching TV. But, long work hours decrease the probability of sports participation. In summary, we provide limited evidence that long work hours in China have deleterious influences on health or lifestyles. Therefore, further research needs to explore the potential impacts of long work hours on other health or lifestyle measures. References Bishop, J.A. Liu, H.Y. & Zheng, B.H. 2010. Rising incomes and nutritional inequality in China. . In: BISHOP, J. A. (ed.) Studies in Applied Welfare Analysis: Papers from the Third ECINEQ Meeting. Bingley: Emerald Group Publishing. Dishion, T.J. & Tipsord, J.M. 2011. Peer contagion in child and adolescent social and emotional development. Annual Review of Psychology, 62, 189-214. Fritjers, P. Johnston, D.W. & Meng, X. 2009. The mental health cost of long working hours: the case of rural Chinese migrants. Mimeo. Greve, J. 2011. New results on the effect of maternal work hours on childrens overweight status: does the quality of child care matter? Labour Economics, 18(5), 579-590. Gwozdz, W. Sousa-Poza, A. Reisch, L.A. Ahrens, W. Henauw, S.D. Eiben, G. Fernandéz-Alvira, J.M. Hadjigeorgiou, C. De Henauw, S. Kovács, E. Lauria, F. Veidebaum, T. Williams, G. & Bammann, K. 2013. Maternal employment and childhood obesity - a European perspective. Journal of Health Economics, 32(4), 728-742. Gale, F. & Huang, K.S. 2007. Demand for food quantity and quality in China, Economic Research Report. No.32. Washington D.C. : US Department of Agriculture. Lu, L. & Luhrmann, M. 2012. The impact of Chinese income growth on nutritional outcomes. Available from Liu, R.D. Pieniak, Z. & Verbeke, W. 2013b. Consumers attitude and behaviour towards safe food in China: a review. Food Control, 33(1), 93-104. Loh, C.P. & Li, Q. 2013. Peer effects in adolescent bodyweight: evidence from rural China. Social Science & Medicine, 86, 35-44. Shankar, B. 2010. Socio-economic drivers of overnutrition in China. Journal of Human Nutrition and Dietetics, 23(5), 471-479. Trogdon, J.G. Nonnemaker, J. & Pais, J. 2008. Peer effects in adolescent overweight. Journal of Health Economics, 27(5), 1388-99. Verité 2004. Excessive overtime in Chinese supplier factories: causes, impacts and recommendations for action. Verité Research Paper, Amherst, Massachusetts. Zhong, F.N. Xiang, J. & Zhu, J. 2012. Impact of demographic dynamics on food consumption: a case study of energy intake in China. China Economic Review, 23(4), 1011-1019. Zhao, Z. 2008. Health demand and health determinants in China. Journal of Chinese Economic and Business Studies, 6(1), 77-98.
Flexible work arrangements and precautionary behaviour : theory and experimental evidence
(2020) Rostam-Afschar, Davud; Orland, Andreas
In the past years, work time in many industries has become increasingly flexible opening up a new channel for intertemporal substitution. To study this, we set up a two-period model with wage uncertainty. This extends the standard saving model by allowing a worker to allocate a fixed time budget between two work shifts or to save. To test the existence of these channels, we conduct laboratory consumption/saving experiments. A novel feature of our experiments is that we tie them to a real-effort style task. In four treatments, we turn on and off the two channels for consumption smoothing: saving and time allocation. Our four main findings are: (i) subjects exercise more effort under certainty than under risk; (ii) savings are strictly positive for at least 85 percent of subjects (iii) a majority of subjects uses time allocation to smooth consumption; (iv) saving and time shifting are substitutes, though not perfect substitutes.
Mismatches between actual and preferred work time : empirical evidence of hours constraints in 21 countries
(2009) Otterbach, Steffen
This paper analyzes the discrepancy between actual and desired working hours in a multinational setting. Using the latest data of the International Social Survey Program (ISSP) with a focus on work orientations hours constraints in 21 heterogeneous countries are analyzed. One major finding is that hours constraints are interrelated with macroeconomic variables such as (i) unemployment rates, (ii) GDP per capita as a measure of welfare, (iii) average weekly work hours, and (iv) income inequality. A subsequent multivariate analysis reveals that, on both macro- and microlevels, sociodemographic variables like prosperity and income, high risk of unemployment, and working conditions play an important role in determining working hours constraints. The results further suggest that, with respect to working conditions, such constraints are also affected by gender issues.
Work hours constraints and health
(2011) Sousa-Poza, Alfonso; Otterbach, Steffen; Bell, David
The issue of whether employees who work more hours than they want to suffer adverse health consequences is important not only at the individual level but also for governmental formation of work time policy. Our study investigates this question by analyzing the impact of the discrepancy between actual and desired work hours on self-perceived health outcomes in Germany and the United Kingdom. Based on nationally representative longitudinal data, our results show that work-hour mismatches (i.e., differences between actual and desired hours) have negative effects on workers´ health. In particular, we show that ?overemployment? ? working more hours than desired - has negative effects on different measures of self-perceived health.
Work time and hours constraints
(2012) Otterbach, Steffen; Sousa-Poza, Alfonso
This thesis aims to draw a comprehensive picture of labor supply hours and the extent and determinants of work hours constraints while pinpointing possible consequences and policy implications of such constraints and highlighting the relevance of individual work time preferences with respect to a meaningful debate on work time issues. Most particularly, it offers a comprehensive analysis of how the consideration of individually preferred work hours and the discrepancy between these and actual work hours can foster an understanding of individual labor market participation decisions. What insights, for example, do individual preferences for work hours provide for successful policy implementation if policy makers address topics such as the length of the work week, balance between work and family life or the need for more substantive part-time jobs? Likewise, what incentives might lead employers to reduce work hour mismatches? Despite their importance, these issues of work hour preferences and constraints have not yet been adequately considered in the overall debate on work time and labor market policy. Nor has attention been paid to a further pivotal question: how these restrictions affect workers´ health and well-being. To date, there are only a few studies that investigate the meaning of work hours constraints in the context of happiness and well-being in the work place. This thesis, therefore, constitutes the first study for Germany and the United Kingdom on the potential adverse health consequences of being constrained in the choice of number of work hours.