Alexander Geissler
Title
Prof. Dr.
Last Name
Geissler
First name
Alexander
Email
alexander.geissler@unisg.ch
ORCID
Phone
+41 71 224 3200
124 results
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Item type:Publication, Occupational health interventions' impact on absenteeism and economic returns: A systematic review and meta-analysis.(2025-12-17); ; Objective: Health-related productivity losses impose a significant burden on health systems and economies. Occupational health interventions (OHI) are increasingly promoted as preventive strategies to reduce work-related illness and enhance productivity. However, their effectiveness often remains unclear, creating a lack of guidance to those deciding on their implementation. The aim of this review was to evaluate the effectiveness of OHI in reducing sickness absenteeism and generating economic returns, focusing on mental health, physical health, and workplace atmosphere interventions (eg, work climate enhancement, leadership training). Methods: A systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline was conducted throughout December 2024. Risk of bias was assessed with Joanna Briggs Institute checklists. A random-effects meta-analysis synthesized OHI effects on sick days and return on investment (ROI). Results: Of 2624 identified studies, 68 across eight industries met eligibility criteria. From these, 23 were included in the meta-analysis: 11 reporting on sick days, and 12 on ROI. OHI were associated with a non-significant reduction in absenteeism [-0.18 days; 95% confidence interval (CI) -2.80-2.43; P=0.890] and a tendency of positive ROI (1.92; 95% CI -0.34-4.17; P=0.096), albeit with statistical uncertainty. Conclusion: We only found effect of OHI on ROI, however, absence effects on sick days do not necessarily imply a lack of effectiveness. We hypothesize that ROI benefits reflect improvements in presenteeism, although not directly measured. Overall, this review guides OHI selection and implementation, urges standardized evaluation, and prioritizes research on presenteeism measurement, non-OECD settings, and qualitative success factors.Type:journal articleJournal:Scandinavian journal of work, environment & healthScopus© Citations 6 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PROM-based monitoring and alerts reduce post-surgery healthcare utilization of patients undergoing joint replacement: A secondary analysis of the PROMoting Quality RCT(Springer Science and Business Media LLC, 2025-08-07); ; Scopus© Citations 4 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Utilization rates of hip arthroplasty in OECD countries revisedObjective: In 2014, we reported rising hip arthroplasty utilization across Organization for Economic Cooperation and Development (OECD) countries, particularly among younger patients. Since then, healthcare systems have evolved, demographic shifts are continued, and procedures were impacted by the COVID-19 pandemic. This study aims to reassess these trends through 2022. Methods: We analyzed hip arthroplasty data from the OECD Health Statistics, U.S. Nationwide Inpatient Sample, and World Bank for 27 countries (2005–2022). We compared relative (compound annual growth rates (CAGR)) and absolute (i.e., mean annual differences (MAD)) procedure numbers, stratified by age (≤64 vs. ≥65), and examined associations with GDP, health expenditure, and life expectancy. Sensitivity analyses were performed to account for uncertainty in U.S. data. Results: Between 2011 and 2022, hip arthroplasty utilization grew more slowly than 2005–2011 (CAGR: 1.00% vs. 2.03%; MAD: 1.78 vs. 2.03). Growth from 2011 to 2022 was concentrated among patients aged ≤64 (CAGR 3.08%; MAD: 3.11), while utilization declined among those ≥65 (CAGR: −2.27%; MAD: −12.46). Country-level variation narrowed, with the highest-to-lowest ratio falling from 6.65 (2005) to 2.96 (2022). Despite a sharp drop in 2020 due to COVID-19, most countries recovered by 2022. Sensitivity analyses confirmed the robustness of observed OECD trends. BRIC nations showed faster growth, but data limitations hindered comparisons. Conclusion: Hip arthroplasty utilization continues to increase among younger patients but has declined in older ones. Continued demographic pressure and recovery from COVID-19 disruptions are expected to drive further increases in procedure volume.Type:journal articleJournal:Osteoarthritis and CartilageScopus© Citations 4 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Retrospective evaluation of interval breast cancer screening mammograms by radiologists and AI(Springer Science and Business Media LLC, 2025-08-04); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Risk factors for interval breast cancer: insights from a decade of a mammography screening program(Springer Science and Business Media LLC, 2025-02-12); ; Scopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A nationwide digital maturity assessment of hospitals – Results from the German DigitalRadar(2024); Scopus© Citations 11 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Medication adherence halves COPD patients' hospitalization risk - Evidence from Swiss health insurance data(2024); ; Medication adherence is vital for patients suffering from Chronic Obstructive Pulmonary Disease (COPD) to mitigate long-term consequences. The impact of poor medication adherence on inferior outcomes like exacerbations leading to hospital admissions is yet to be studied using real-world data. Using Swiss claims data from 2015-2020, we group patients into five categories according to their medication possession ratio. By employing a logistic regression, we quantify each category’s average treatment effect of the medication possession ratio on hospitalized exacerbations. 13,557 COPD patients are included in the analysis. Patients with high medication adherence (daily medication reserve of 80% to 100%) are 51% less likely to incur exacerbation following a hospital stay than patients with the lowest medication adherence (daily medication reserve of 0% to 20%). The study shows that medication adherence varies strongly among Swiss COPD patients. Furthermore, high medication adherence immensely decreases the risk of hospitalized exacerbations.Type:journal articleScopus© Citations 19 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A Collection of Components to Design Clinical Dashboards Incorporating Patient-Reported Outcome Measures: Qualitative Study(2024); ; ; Scopus© Citations 9 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, How to interpret patient-reported outcomes? - Stratified adjusted minimal important changes for the EQ-5D-3L in hip and knee replacement patients(Springer Science and Business Media LLC, 2024-11-25); ; ; ; Abstract Background As one of the main goals of hip and knee replacements is to improve patients’ health-related quality of life, a meaningful evaluation can be achieved by calculating minimal important changes (MICs) for improvements in patient-reported outcome measures (PROMs). This study aims at providing MICs adjusted for patient characteristics for EQ-5D-3L index score improvements after hip and knee replacements. It adds to existing literature by relying on a large national sample and precise clustering algorithms, and by employing a state-of-the-art methodology for the calculation of improved adjusted MICs. Methodology A retrospective observational study was conducted using the publicly available National Health Service (NHS) PROMs dataset for primary hip and knee replacements. We used information on 252,331 hip replacements and 279,668 knee replacements from all NHS-funded providers in England between 2013 and 2020. Clusters of patients were created based on pre-operative EQ-VAS, depression status, and sex. Unstratified and stratified estimates for meaningful EQ-5D-3L improvements were obtained through anchor-based predictive MICs corrected for the proportion of improved patients and the reliability of transition ratings Results Stratifying patients showed that MICs varied across subgroups based on pre-operative EQ-VAS, depression status, and sex. MICs were larger for patients with worse pre-operative EQ-VAS scores, while patients with better pre-operative scores required smaller MICs to achieve a meaningful change. We show how after stratification the percentage of patients achieving their stratified MIC was better in line with the actual share of improved patients. Larger MICs were found for patients with depression and for female patients. MICs calculated for knee replacements were consistently lower than those for hip replacements. Conclusions Our findings show the importance of adjusting MICs for patients’ characteristics and should be considered for quality-related choices and policy initiatives.Type:journal articleJournal:Journal of Patient-Reported OutcomesVolume:8Issue:1Scopus© Citations 3 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Assessing the Relationship between Hospital Process Digitalization and Hospital Quality - Evidence from Germany.(2024-09-13); ; Hospital digitalization aims to increase efficiency, reduce costs, and/ or improve quality of care. To assess a digitalization-quality relationship, we investigate the association between process digitalization and process and outcome quality. We use data from the German DigitalRadar (DR) project from 2021 and combine these data with two process (preoperative waiting time for osteosynthesis and hip replacement surgery after femur fracture, n = 516 and 574) and two outcome quality indicators (mortality ratio of patients hospitalized for outpatient-acquired pneumonia, n = 1,074; ratio of new decubitus cases, n = 1,519). For each indicator, we run a univariate and a multivariate regression. We measure process digitalization holistically by specifying three models with different explanatory variables: (1) the total DR-score (0 (not digitalized) to 100 (fully digitalized)), (2) the sum of DR-score sub-dimensions' scores logically associated with an indicator, and (3) sub-dimensions' separate scores. For the process quality indicators, all but one of the associations are insignificant. A greater DR-score is weakly associated with a lower mortality ratio of pneumonia patients (p < 0.10 in the multivariate regression). In contrast, higher process digitalization is significantly associated with a higher ratio of decubitus cases (p < 0.01 for models (1) and (2), p < 0.05 for two sub-dimensions in model (3)). Regarding decubitus, our finding might be due to better diagnosis, documentation, and reporting of decubitus cases due to digitalization rather than worse quality. Insignificant and inconclusive results might be due to the indicators' inability to reflect quality variation and digitalization effects between hospitals. For future research, we recommend investigating within hospital effects with longitudinal data.Type:journal articleJournal:Journal of medical systemsVolume:48Issue:1Scopus© Citations 1