Abstract
BackgroundHealth impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. A large number of instruments exist to measure health-related productivity changes; however their methodological quality remains unclear. This systematic review critically appraised the measurement properties in generic self-reported instruments that measure health-related productivity changes to recommend appropriate instruments for use in occupational and economic health practice.MethodsPubMed, PsycINFO, Econlit and Embase were systematically searched for studies whereof: (i) instruments measured health-related productivity changes; (ii) the aim was to evaluate instrument measurement properties; (iii) instruments were generic; (iv) ratings were self-reported; (v) full-texts were available. Next, methodological quality appraisal was based on COSMIN elements: (i) internal consistency; (ii) reliability; (iii) measurement error; (iv) content validity; (v) structural validity; (vi) hypotheses testing; (vii) cross-cultural validity; (viii) criterion validity; and (ix) responsiveness. Recommendations are based on evidence syntheses.ResultsThis review included 25 articles assessing the reliability, validity and responsiveness of 15 different generic self-reported instruments measuring health-related productivity changes. Most studies evaluated criterion validity, none evaluated cross-cultural validity and information on measurement error is lacking. The Work Limitation Questionnaire (WLQ) was most frequently evaluated with moderate respectively strong positive evidence for content and structural validity and negative evidence for reliability, hypothesis testing and responsiveness. Less frequently evaluated, the Stanford Presenteeism Scale (SPS) showed strong positive evidence for internal consistency and structural validity, and moderate positive evidence for hypotheses testing and criterion validity. The Productivity and Disease Questionnaire (PRODISQ) yielded strong positive evidence for content validity, evidence for other properties is lacking. The other instruments resulted in mostly fair-to-poor quality ratings with limited evidence.ConclusionsDecisions based on the content of the instrument, usage purpose, target country and population, and available evidence are recommended. Until high-quality studies are in place to accurately assess the measurement properties of the currently available instruments, the WLQ and, in a Dutch context, the PRODISQ are cautiously preferred based on its strong positive evidence for content validity. Based on its strong positive evidence for internal consistency and structural validity, the SPS is cautiously recommended.
Highlights
Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole
When information about the costs of alternative treatments is to be used to guide healthcare policy decision making, it is the total budget needed to treat patients with the disease that is relevant. Estimates of these total costs are based on various cost categories, such as direct health care costs and indirect healthcare costs
Various studies on different diseases have shown that indirect costs, called ‘productivity costs’, contributed substantially to total costs, illustrating how important the consequences of disease are for work performance [1,2,3,4]
Summary
Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. When information about the costs of alternative treatments is to be used to guide healthcare policy decision making, it is the total budget needed to treat patients with the disease that is relevant Estimates of these total costs are based on various cost categories, such as direct health care costs (costs of healthcare resources used by patients) and indirect healthcare costs (costs due to lost productivity). As it is known, health impairments among workers can result in considerable costs due to work disability, sickness absence, and productivity loss at work, all imposing a substantial financial burden for the employee, employer and society as a whole. Presenteeism costs, or costs due to reduced productivity while still at work, appeared to represent up to 60% of all costs [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
