Economic Analysis of Workplace Violence and Its Impact on Karachi, Pakistan’s Healthcare System
Workplace Violence and Economic Costs in Gynecology and Pediatric Care
DOI:
https://doi.org/10.62807/jowach.v2i1.2025.12-20Keywords:
Workplace violence, Healthcare costs, Absenteeism, Turnover, Care qualityAbstract
ABSTRACT
Background:
Workplace violence against healthcare providers disrupts care delivery and imposes serious financial strain on health systems. This study quantifies the economic costs of violence, focusing on absenteeism, staff turnover, and reduced care quality in Karachi, Pakistan.
Methods:
A cross-sectional study was conducted among 414 healthcare providers across pediatric and gynecology departments in Karachi. Financial costs due to absenteeism, turnover, and quality losses were estimated using average wage data, replacement costs, and revenue impact metrics. Statistical analyses were performed using SPSS version 21.
Results:
The annual financial burden of workplace violence was estimated at PKR 24.9 million. Absenteeism contributed PKR 1.66 million, staff turnover PKR 7.2 million, and care quality losses PKR 11.8 million. Significant statistical associations were observed between types of violence and each financial metric.
Conclusions:
Workplace violence imposes a measurable and critical financial burden on healthcare systems. Targeted policies and safety interventions are essential to mitigate violence and ensure efficient, safe, and sustainable healthcare delivery in high-risk departments.
Keywords: Workplace violence, healthcare costs, absenteeism, turnover, care quality,
References
Vento S, Cainelli F, Vallone A. Violence against healthcare workers: a worldwide phenomenon with serious consequences. Front Public Health. 2020;8:570459. Available from: https://doi.org/10.3389/fpubh.2020.570459
Alharbi F. , Alzneidi N. , Aljbli G. , Morad S. , Alsubaie E. , Mahmoud M. et al.. Workplace violence among healthcare workers in a tertiary medical city in riyadh: a cross-sectional study. Cureus 2021. https://doi.org/10.7759/cureus.14836
Caruso R. , Toffanin T. , Folesani F. , Biancosino B. , Romagnolo F. , Riba M. et al.. Violence against physicians in the workplace: trends, causes, consequences, and strategies for intervention. Current Psychiatry Reports 2022;24(12):911-924. https://doi.org/10.1007/s11920-022-01398-1
Pagnucci N. , Ottonello G. , Capponi D. , Catania G. , Zanini M. , Aleo G. et al.. Predictors of events of violence or aggression against nurses in the workplace: a scoping review. Journal of Nursing Management 2022;30(6):1724-1749. https://doi.org/10.1111/jonm.13635
Cho M. , Min K. , & Min J.. Workplace violence experienced by personal care workers in a district in seoul, republic of korea: a comparison study with office and service workers. Healthcare 2024;12(3):320. https://doi.org/10.3390/healthcare12030320
Gedik Ö. , Şimdi R. , Kıbrıs Ş. , & Kara D.. The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the covid-19 pandemic. Journal of Research in Nursing 2023;28(6-7):448-466. https://doi.org/10.1177/17449871231182837
Alobaidan F. , Bazroun M. , Aman H. , Jaroudi S. , Qattan A. , Hbiesheh A. et al.. Emergency department violence: a growing challenge for healthcare workers in saudi arabia. Cureus 2024. https://doi.org/10.7759/cureus.52455
Ko H. , Kim D. , Cho S. , Lee D. , Choi J. , Kim M. et al.. The association of emotional labor and workplace violence with health-related productivity loss. Journal of Occupational Health 2024;66(1). https://doi.org/10.1093/joccuh/uiae057
Yasmin R. and Mubarak N.. The relationship between workplace violence and turnover intention with a mediating role of work engagement and job satisfaction. Jinnah Business Review 2021;9(2):112-124. https://doi.org/10.53369/zyoy5815
Akram J. , Azhar S. , Khan K. , & Aman A.. Patient safety attitudes of frontline healthcare workers in lahore: a multicenter study. Pakistan Journal of Medical Sciences 2021;38(1). https://doi.org/10.12669/pjms.38.1.4964
Yusoff HM, Ahmad H, Ismail H, Reffin N, Chan D, Kusnin F, et al. Contemporary evidence of workplace violence against the primary healthcare workforce worldwide: a systematic review. Hum Resour Health. 2023;21(1):82. Available from: https://doi.org/10.1186/s12960-023-00868-8
O'Brien CJ, van Zundert AAJ, Barach PR. The growing burden of workplace violence against healthcare workers: trends in prevalence, risk factors, consequences, and prevention—a narrative review. EClinicalMedicine. 2024 Jun;72:102641. doi: 10.1016/j.eclinm.2024.102641. Available from: https://doi.org/10.1016/j.eclinm.2024.102641.
Shahjalal M, Mosharaf MP, Mahumud RA. Effect of workplace violence on health workers' injuries and workplace absenteeism in Bangladesh. Glob Health Res Policy. 2023;8(1):33. Available from: https://doi.org/10.1186/s41256-023-00316-z
Jones CB, Sousane Z, Mossburg S. Addressing Workplace Violence and Creating a Safer Workplace. PSNet [Internet]. Rockville (MD): Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2023 [cited 2025 Mar 28]. Available from: https://psnet.ahrq.gov/perspective/addressing-workplace-violence-and-creating-safer-workplace
Yang Y, Wang P, Kelifa MO, Wang B, Liu M, Lu L, et al. How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health. J Nurs Manag. 2022;30(6):1407–14. Available from: https://doi.org/10.1111/jonm.13325
Ilikannu CO, Uwaezuoke AC, Ilikannu SO, et al. Violence against healthcare workers in a tertiary hospital in southern Nigeria: a descriptive cross-sectional study. Discov Public Health. 2025;22:53. Available from: https://doi.org/10.1186/s12982-025-00431-x
O'Brien CJ, van Zundert AAJ, Barach PR. The growing burden of workplace violence against healthcare workers: trends in prevalence, risk factors, consequences, and prevention—a narrative review. EClinicalMedicine. 2024;72:102641. Available from: https://doi.org/10.1016/j.eclinm.2024.102641.

Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Tasneem Muffaddal, Muhammad Bilal Siddiqui, Muhammad Suleman Otho (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal of Women and Child Health (JoWaCH) adheres to the CC BY 4.0 license, which is a Creative Commons Attribution 4.0 International License. For comprehensive information, we kindly request that you refer to the full license legal code. JoWaCH employs a non-exclusive license agreement for the purpose of open-access publication. In the context of open access publishing, the authors maintain the copyright of their work while also granting the journal the rights to publish and distribute it, while retaining the primary academic use rights. This practice facilitates the optimal use and dissemination of the work, while also guaranteeing proper attribution to the original source. The handling of manuscript content shall be conducted with confidentiality, with the exception of cases involving review processes and investigations related to potential misconduct, plagiarism, and duplicate/redundant or overlapping publications, in accordance with the guidelines provided by the Committee on Publication Ethics (COPE) COPE Guidelines.
JoWaCH is prohibited from disseminating content derived from previously published scientific work without obtaining proper authorization. Obtaining permission from the copyright holder, who may be either the author(s) or the publisher, is necessary in cases where the copyright holder is the publisher, for any work you want to use.
While it is acceptable to use a small amount of a work, obtaining permission from the copyright owners is necessary for a significant extraction.
The use of unmodified or little modified tables, graphs, and artworks (whether they are the user's own work previously published elsewhere or created by another copyright holder) necessitates obtaining permission.
Tables, graphs, charts, and artworks that have been fully redesigned and rebuilt, and include proper reference of the source, do not need obtaining permission.
JoWaCH facilitates unrestricted access to journal material for readers, necessitating the imposition of membership fees. The journal operates on a self-sustaining financial model and does not rely on support from other sources. The procedure of publishing is contingent only upon the financial resources of the publisher. The readers have unrestricted access to the information on the journal website.