Quasi-experimental evaluation of a digital occupational health management system on presenteeism and work efficiency among healthcare workers.

Background: Presenteeism, defined as working while unwell, is a common occupational health issue that compromises healthcare worker wellbeing, work efficiency, and patient safety. High workload, insufficient organizational support, and limited systematic health management may exacerbate presenteeism in hospital settings. This study aimed to develop and evaluate a Digital Occupational Health Management System (OHMS), grounded in the Job Demands-Resources model, to reduce presenteeism and improve work-related outcomes among healthcare workers. Methods: A quasi-experimental pre-post study with a matched contemporaneous control group was conducted among healthcare workers at Taizhou Fourth People's Hospital, Jiangsu, China. The OHMS was implemented over 12 months, with the primary effectiveness assessment performed at 6 months and the subsequent 6 months used for continued monitoring, implementation maintenance, and system optimization. A total of 300 healthcare workers were included in the OHMS intervention group, and 300 contemporaneous non-intervention controls were selected using the same eligibility criteria after propensity score matching. The primary outcome was presenteeism, assessed using the Stanford Presenteeism Scale-6. Secondary outcomes included psychological wellbeing, emotional exhaustion, and objective work performance indicators. Difference-in-differences analysis was used as the primary analytical approach. Results: After OHMS deployment, 286 of 300 participants completed system registration, with a registration rate of 95.3%. The average monthly active usage rate during the 6-month primary evaluation period was 82.4%. Compared with the matched control group, the intervention group showed greater reductions in presenteeism, emotional exhaustion, sick leave days, overtime hours, and absenteeism rate, as well as greater improvements in psychological wellbeing and work efficiency. Multiple regression showed that workload was positively associated with presenteeism, whereas organizational support, system usage frequency, and wellbeing were negatively associated with presenteeism. Structural equation modeling supported a pathway in which workload increased presenteeism directly and indirectly through reduced wellbeing. Conclusion: The OHMS intervention was associated with reduced presenteeism, improved psychological wellbeing, and better work-related performance. Longer follow-up and multicenter validation are warranted.