Are nursing home care workers' health and presenteeism associated with implicit rationing of care? A cross-sectional multi-site study.

To explore associations between care workers' health and implicit rationing of care. Diverse studies have linked impaired health to reduced work performance - a factor measured through omission of required tasks. This cross-sectional study gathered data from 3239 care workers in 162 Swiss nursing homes. Data were analyzed via a linear logistic regression model using general estimating equations. Overall, rationing of care occurred "never" to "seldom." Rationing of activities of daily living was positively associated with care workers' joint pain (β 0.04, CI 0.001-0.07), emotional exhaustion (β 0.11, CI 0.07-0.15), and presenteeism (β 0.05, CI 0.004-0.09). Rationing of caring, rehabilitation, and monitoring was positively associated with care workers' joint pain (β 0.05, CI 0.01-0.09) and emotional exhaustion (β 0.2, CI 1.16-0.24). Care workers health complaints are strongly associated with rationing of tasks directly related to resident care.