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The high sick time may be a serious challenge to the effective use of budget funds because sick time increases spending and decreases the effectiveness of employees’ performance. In such a context, it is possible to refer to the cost-effectiveness theory which stresses the importance of the effective use of available funds and optimization of expenses along with the reduction of spending. However, it is important to minimize spending through the optimization of the work of the staff and effective use of employees. In this respect, it is important to lay emphasis on the fact that the introduction of cost-effectiveness principles in the health care setting should not be harmful for patients that means that employees working in the health care setting should focus on the effectiveness of their work that can be reached through the minimization of the sick time.
In actuality, the organizational performance suffers mainly from the high sick time, which undermines the effectiveness of the organizational performance and, to a certain extent, paralyzes functioning of the organization. At the same time, the development of the budget management is vulnerable to the negative impact of the high sick time because the organization has to spend substantial funds on sick time and coverage of sick leaves of employees, whereas employees do not work during their sick leave that naturally leads to the drop of their productivity.
Since the use of sick leave has a significant impact on the organizational management, to the extent that, in the most extreme cases, it can paralyze the functioning of organizations, though it is rather a hypothetical possibility than a highly probable prospect, the organizational management should focus its efforts on the optimization of the use of sick leave. In this regard, it is possible to recommend the development of positive relationships with employees which should be based on the mutual responsibility of managers and employees. However, it is obvious that the mutual responsibility is mainly relies on the ethical agreement between managers and employees than on the legal norms.
Speaking about the responsibilities of employees, it should be said that employees should make every reasonable effort to be present on scheduled workdays. In fact, they should not seek the possibility to avoid fulfilling their duties, including the use of sick leave as a reasonable pretext to avoid attending their workplace. The organizational management can meet this goal only on the condition of the high morale of employees because, if they are not confident that their devotedness to their service will be rewarded, not obligatory in the form of financial bonuses, they will be more likely to do their best and avoid unreasonable absenteeism.
In response, the responsibility of managers should include systematical monitoring employee attendance through observation and computer reports and do not create artificial obstacles to employees who are taking their sick leaves, if they have proved to be responsible and their sick leave is reasonable. In this respect, manager cannot fully rely on the position of employees themselves.

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In actuality, managers need an effective system of control which allows them to define whether a employees’ sick leave is reasonable or probably he simply tends to absenteeism. In such a situation, managers should use observation of employees in order to be able to identify questionable use of sick leave. The questionable use of sick leave is characterized by the seemingly intentional desire of employees to take the leave or a very frequent use of sick leaves and very fast recovery of the employee (Alison and Heymann, 2004). If a manager identifies a questionable use of sick leave should discuss the record with the employee and give him an opportunity to explain. In such a way, the manager will warn the employee that the unreasonable use of sick leave is unacceptable.
In addition, it is necessary to develop special management programs which can correct the behavior of employees susceptible to absenteeism or unreasonable use of sick leaves. For instance, these employees can have certain disadvantages in their schedule compared to those employees who are responsible and avoid absenteeism. Also, it is important to involve other employees in the analysis of the cases of unreasonable use of sick leave. At this point, it is possible to use a kind of group work, in which employees who tend to use sick leave unreasonably should explain their actions to other employees and the group should decide whether some punitive measures should be undertaken in regard to the employee or not. In fact, this measure may be not really effective in relation to the employee who has already used sick leave unreasonably, but it is very effective in relation to other employees who consider the possibility of the unreasonable use of their sick leave. Obviously, the group work shows all of the employees that the unreasonable use of sick leaves is unacceptable for their colleagues, who apparently condemn such practices because it is them who should work for those employees who use sick leaves unreasonably. Naturally, this group work shapes a positive model of behavior when the unreasonable use of sick leave is perceived as abnormal and negative action in regard to colleagues.
However, the punishment or limitation of sick leaves should not be excessive. The organizational management should admit acceptable excessive absenteeism that means that employees can have a leave when they need it badly, even if they have purely personal motives, such as a desire to spend a day with their family. This practice is acceptable as long as absenteeism is not systematic. Moreover, it is necessary to avoid abuse of leave and tardiness in taking decisions concerning sick leave.
It proves beyond a doubt that the minimization of the sick time can improve the effectiveness of budget management. What is meant here is the fact that the organizational management should focus on the implementation of the cost-effectiveness theory. To put it more precisely, the cost-effectiveness can be reached through the introduction of the thorough control over the use of sick leaves by the staff. Furthermore, it is necessary to encourage employees to lead a healthy life style to minimize the risk of falling ill and, thus, taking sick leave. In such a way, employees can avoid taking sick leave and work more effectively and productively. In addition, managers should optimize the work of employees to replace those professionals who are on their sick leave and cannot fulfill their professional duties.
Furthermore, managers should work on the higher responsibility of employees to avoid cases of absenteeism, when employees can work but prefer to take their sick leave. At the same time, managers should pay a lot of attention to the recruitment of employees who are not inclined to taking sick leave. However, the health should not become a criterion for choice of an employee but rather the lifestyle of employees and their professionalism. The latter implies the responsibility of employees and their readiness to work hard.
Thus, taking into account all above mentioned, it is possible to conclude that in order to avoid negative effects of sick leaves on the organizational management and optimize the use of sick leaves and work of organizations, it is necessary to introduce mutual responsibilities and conduct reasonable policies which can allow employees to take sick leave reasonably but not excessively. In this respect, the budget management should focus on the introduction of principles of cost-effectiveness. What is meant here is the fact that the development of cost-effective approach to budget management should be grounded on the minimization of costs through optimization of expenditures of the organization. In such a situation, the improvement of the effectiveness of work of employees should be backed up with the rational use of available funds. Therefore, through balancing of spending and available financial resources the organization can maintain the effective budget management.

 
References:
Alison, E. and S.J. Heymann. (2004). “Work, Family, and Social Class In How Healthy Are We?” A National Study of Well-Being at Midlife. OG. Brim, C.D. Ryff, and R.C. Kessler, eds., Chicago: The University of Chicago Press: 485-513.
Brief, A.P. and H.M. Weiss. (2000). “Organizational Behavior: Affect in the Workplace.” Annual Review of Psychology, 25, p.34-41.