A Healthy Healthcare Workforce? Sick and Annual Leave Patterns in Victorian Healthcare Workers, 2012 to 2024

PURPOSE: To examine sick and annual leave trends across a statewide public health service workforce as lead indicators of workforce wellbeing and identify differences by worker characteristics and occupational factors. METHODS: An ecological study using aggregated leave data over 13-years (July 2011-June 2024) covering most employees at publicly funded hospitals in Victoria, Australia. Joinpoint and negative binomial regression were the main analytical approaches. RESULTS: Between 2012 and 2024, there was a 56% increase in the number of Full-Time Equivalent (FTE) employees. Accumulated annual leave balances increased from 16.6 days per FTE in 2012 to 20.6 days in 2024, with larger increases post-2019 during the COVID-19 pandemic. Sick leave rates increased by 11% between 2012 and 2014, and then decreased, to an average of 9.2-10.2 days. Female gender and older age were associated with higher sick leave taken and annual leave balances. Relative to administration and clerical workers, doctors took the least sick leave (IRR 0.36 [95% Confidence Interval (95% CI) 0.34, 0.39)] and had the lowest annual leave balances [IRR 0.56 (95% CI 0.54, 0.58)]. CONCLUSION: The COVID-19 pandemic appears to have contributed to a change in Victorian public hospital workers ability or desire to take annual leave, with ongoing effects. Workers have accumulated more annual leave since the pandemic, reflecting a possible reduction in annual leave days taken, which poses potential risks to workforce health such as fatigue or burnout. While this study is specific to Australia, the findings provide insights for other high-income healthcare systems with similar paid leave entitlements. Research on workforce health is essential to support workforce wellbeing and health system sustainability.