Sick pay systems are critical in balancing the economic and health costs of infectious diseases, especially in workplaces, where uncontrolled disease spread can lead to significant economic losses. Surprisingly, most research on sick-pay reforms does not rely on variation in worker exposure to disease when investigating absences from work. This paper studies the effects of exposure to influenza outbreaks on absences from work when a nation-wide policy canceled health-insurance coverage for the first 3 days of illness. We explore geographic variation in the prevalence of infectious diseases, primarily the seasonal flu, to identify corresponding variations in the need for sickness insurance. Estimates based on the Czech Structure of Earnings Survey imply that when sickness insurance was canceled for the first 3 days of an illness, the total hours of work missed were not affected, but employees relied on paid and unpaid leave instead of sick-leave to stay home. The substitution effects are heterogeneous across occupations and socio-demographic characteristics of employees, and suggest that workers did not increase the spread of infectious illness in workplaces due to a lack of insurance coverage for the first 3 days of an illness.

中文翻译：

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带病工资和缺勤：流感暴露的证据

病假工资制度对于平衡传染病的经济和健康成本至关重要，特别是在工作场所，不受控制的疾病传播可能导致重大经济损失。令人惊讶的是，大多数有关病假工资改革的研究在调查缺勤情况时并不依赖于工人患病风险的变化。本文研究了当全国范围内的政策取消了患病前 3 天的健康保险时，接触流感爆发对缺勤的影响。我们探索传染病（主要是季节性流感）流行的地理差异，以确定疾病保险需求的相应差异。根据捷克收入结构调查的估计表明，当疾病前三天取消疾病保险时，缺勤的总时间不受影响，但员工依靠带薪和无薪休假而不是病假来留下来家。不同职业和雇员的社会人口特征之间的替代效应存在差异，这表明，由于缺乏疾病前 3 天的保险，工人并没有增加工作场所传染病的传播。