Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter

Roland Eßl-Maurer,Maria Flamm,Jürgen Osterbrink,Antje Van Der Zee-Neuen,Katharina Hösl

doi:10.1007/s00420-021-01788-7

Abstract

PurposeDepression is a highly prevalent mental health condition with substantial individual, societal and economic consequences. This study focussed on the association of depressive symptom severity with absenteeism duration and employer labour costs.MethodsUsing cross-sectional data from the German Health Update 2014/2015, multivariable zero-inflated Poisson regression (ZIP) models explored the association of depressive symptom severity (8-item depression patient health questionnaire—PHQ-8), with absenteeism weeks during 12 months in men and women working full- or part-time. The predicted sick leave weeks were multiplied by mean average labour costs.ResultsThe sample consisted of 12,405 persons with an average sick leave of 1.89 weeks (SD 4.26). Fifty-four % were women and 57% were between 40 and 59 years of age. In men and women, mild, moderate, moderately severe and severe depressive symptoms were associated with a significant factor increase in sick leave weeks compared to persons with no or minimal symptoms. Labour costs increased with increasing symptom severity from € 1468.22 for men with no or minimal depressive symptoms to € 7190.25 for men with severe depressive symptoms and from € 1045.82 to € 4306.30 in women, respectively.ConclusionThe present results indicate that increasing depressive symptom severity is associated with increasing absenteeism and employer costs. They emphasize the need for implementation, realignment or extension of professional work-site health promotion programmes aiming at the improvement and maintenance of employee health and the reduction of labour costs associated with depression-related sick leave.

Highlights

Depression is one of the most common and consequential mental illnesses (Murray et al 2013) and is estimated to affect 350 million people worldwide (Marcus et al 2012)
The present study showed that sick leave and costs for employers of persons with depressive symptoms rise substantially with increasing, self-reported symptom severity
This is the first study focussing on the association of depressive symptom severity with absenteeism and related costs in the European region

Summary

Introduction

Depression is one of the most common and consequential mental illnesses (Murray et al 2013) and is estimated to affect 350 million people worldwide (Marcus et al 2012). For a diagnosis of depression, symptoms must have lasted for at least 2 weeks (DIMDI 2019). Depression and anxiety disorders cost the global economy an estimated US$1 trillion per year (WHO 2019). Costs of depression include direct costs through healthcare utilization and indirect costs attributable to decreased worker productivity. The prevalence of depression in persons contributing to the workforce is considerable and is associated with decreased work productivity including absenteeism (Henderson and Madan 2014; Musarezaie et al 2014). In Germany, employers are legally obliged to continuous payment of salary for a maximum period of six consecutive weeks in case of sickness-related absenteeism resulting in excess labour costs without employee output during episodes of sick leave (Federal Government Commissioner for Migration, Refugees and Integration 2020)

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Results

Conclusion