At-work Productivity Research Articles

Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA

To explore the impact of at-work productivity loss on the total productivity cost by different instruments in patients recently diagnosed with RA and controls without RA. Cross-sectional data were collected from outpatients with RA between December 2007 and February 2008. The control group was formed by subjects without RA matched on age and gender. Absenteeism and presenteeism were estimated by the Quantity and Quality (QQ) Questionnaire, Work Productivity and Activity Impairment Questionnaire General Health V2.0 (WPAI-GH) and Health and Labor Questionnaire (HLQ) questionnaires. Differences between groups were tested by Mann-Whitney U-test. Costs were valued by the human capital approach. Data were available from 62 patients with a paid job and 61 controls. QQ- and WPAI-GH scores of presenteeism were moderately correlated (r = 0.61) while the HLQ presenteeism score correlated poorly with the other instruments (r = 0.34). The contribution of presenteeism on total productivity costs was estimated at ∼70% in the RA group. The mean costs per person per week due to presenteeism varied between €79 and €318 per week in the RA group, dependent on the instrument used. The costs due to presenteeism were about two to four times higher in the RA group compared with the control group. This study indicates that the impact of presenteeism on the total productivity costs in patients with RA is high. However, work productivity in individuals without RA was not optimal either, which implies a risk of overestimation of cost when a normal score is not taken into account. Finally, different presenteeism instruments lead to different results.

The Impact of Precancerous Cervical Lesions on Functioning at Work and Work Productivity

To assess the work performance and productivity impact of human papillomavirus (HPV). A cross-sectional study compared 94 employed women with clinically significant HPV-related cervical lesions with 118 healthy controls. Data were collected by self-administered web-based questionnaire. At-work performance limitations and productivity loss (presenteeism) and absenteeism were measured. Univariate and multivariate case-control group and clinical subgroup differences were tested. Based on adjusted mean scores, the HPV group had significantly more at-work limitations and productivity loss than controls (P = 0.009), higher absence rates (P = 0.002), and significantly more productivity loss because of absences (P = 0.007). At-work limitations varied in association with martial status (P = 0.025); at-work productivity loss was associated with years of education (P = 0.039). HPV is costly for working women, their employers, and the economy.

Reliability, validity, and responsiveness of five at‐work productivity measures in patients with rheumatoid arthritis or osteoarthritis

Arthritis often impacts a worker's ability to be productive while at work. However, the ideal approach to measuring arthritis-attributable at-work productivity loss remains unclear. Our objective was to evaluate the relative strengths and weaknesses of 5 measures aimed at quantifying health-related at-work productivity loss and to determine the best available instrument for this population. In a 12-month longitudinal design, the psychometric properties (reliability, validity, and responsiveness) of 5 self-reported measures of at-work productivity were compared in workers with either rheumatoid arthritis (RA) or osteoarthritis (OA). We tested the Workplace Activity Limitations Scale (WALS), 6-item Stanford Presenteeism Scale (SPS-6), Endicott Work Productivity Scale (EWPS), RA Work Instability Scale (WIS), and Work Limitations Questionnaire (WLQ). Across all measures, participants (n = 250, 120 with RA and 130 with OA) consistently reported mild losses of at-work productivity. The Cronbach's alpha of the scales ranged from 0.71 (for SPS-6) to 0.94 (for EWPS), indicating some concerns over the internal consistency of the SPS-6. The RA WIS demonstrated the strongest construct validity (|r| = 0.54-0.74), whereas the WALS was most responsive to perceived changes in work ability. Despite its increasing popularity and potential application for costing analysis, the WLQ did not compare favorably with the other scales, possibly due to psychometric concerns with its physical demands subscale. Measures revealed unique conceptualization of at-work disability, but no single scale emerged as clearly superior. However, current results slightly favor the WALS and RA WIS as superior instruments for measuring at-work productivity loss in workers with arthritis.

Measuring Worker Productivity: Frameworks and Measures

Worker productivity is a combination of time off work (absenteeism) due to an illness and time at work but with reduced levels of productivity while at work (also known as presenteeism). Both can be gathered with a focus on application as a cost indicator and/or as an outcome state for intervention studies. We review the OMERACT worker productivity groups' progress in evaluating measures of worker productivity for use in arthritis using the OMERACT filter. Attendees at OMERACT 9 strongly endorsed the importance of work as an outcome in arthritis. Consensus was reached (94% endorsement) for fielding a broader array of indicators of absenteeism. Twenty-one measures of at-work productivity loss, ranging from single item indicators to multidimensional scales, were reviewed for measurement properties. No set of at-work productivity measures was endorsed because of variability in the concepts captured, and the need for a better framework for the measurement of worker productivity that also incorporates contextual issues such as job demands and other paid and unpaid life responsibilities. Progress has been made in this area, revealing an ambivalent set of results that directed us back to the need to further define and then contextualize the measurement of worker productivity.

A Method for Imputing the Impact of Health Problems on At-Work Performance and Productivity From Available Health Data

To develop a method for imputing the work performance and productivity impact of illness and treatment from available data. Using data from four studies of musculoskeletal disorders (eg, osteoarthritis) and pain, we modeled the relationships between scores from the Work Limitations Questionnaire (WLQ), a validated measure of health-related limitations in work performance and productivity, and a series of validated health measures (eg, a pain scale). The 15 health and 5 WLQ variables were significantly associated in 115 of 116 study-specific models (P < 0.05). Fifteen commonly collected health variables may be used to predict WLQ impact (increase or decrease) for samples with musculoskeletal pain and physical impairments to help fill information gaps.

A proof‐of‐concept study of the “employment and arthritis: Making it work” program

Work disability is a common outcome of inflammatory arthritis (IA), yet few services address employment. We conducted a proof-of-concept study of the "Employment and Arthritis: Making It Work" self-management program aimed at preventing work disability and maintaining at-work productivity in employed people with IA. The program was developed using the precede-proceed model and self-management concepts. Program goals included modifying risk factors for work disability and enhancing self-management of work problems due to IA, as identified in initial focus groups. The program included a self-learning manual, 5 group sessions, and individual visits with an occupational therapist for an ergonomic assessment and a vocational rehabilitation counselor. It was pilot tested in 2 groups (n = 19) and evaluated over 12 months of followup. Participants consisted of 19 employed women with IA. Process evaluation demonstrated feasibility and excellent attendance and use of the self-learning manual. By 1 year, 80% reported increased confidence in requesting job accommodations, 74% had requested an accommodation, and 71% of requested accommodations were implemented. The occupational therapist and vocational rehabilitation counselor visits resulted in recommendations for change in 100% and 74% of participants, respectively, with implementation of some recommended changes in 89% and 63%, respectively. Improvements were observed in self-confidence in managing problems at work, fatigue interference with work, measures of limitations, and at-work productivity. We developed a novel intervention to prevent work disability in patients with IA, combining self-management group sessions and professional assessments aimed at job retention, which resulted in people making changes to adapt their work to their arthritis, and improved fatigue, self-efficacy, and at-work productivity.

Impaired Work Performance Among Women With Symptomatic Uterine Fibroids

To assess the work impact of symptomatic uterine fibroids (UFs). A cohort study compared 58 employed women with symptomatic UFs to 56 healthy controls. Data sources included a self-administered mail questionnaire and medical charts. At-work performance limitations and productivity loss were measured with the Work Limitations Questionnaire. Univariate and multivariate case-control group differences were tested. Based on adjusted mean scores, the UF group had significantly more at-work limitations and productivity loss than controls, while absence rates were similar. The UF group's performance was impaired 18% of the time on average versus 8% for controls (P-values, 0.005-0.040). At-work limitations were explained by depression symptoms, Non-White race/ethnicity, and poorer health-related quality of life. Fibroids and related symptoms impose a burden on the working lives' of women, their employers, and the economy.

The ergonomic assessment tool for arthritis: Development and pilot testing

Ergonomic assessment and recommendations may help people with arthritis maintain employment; however, most ergonomic tools are designed to assess injury risk in the general population and are not specific to the needs of people with inflammatory arthritis (IA). Our objectives were to design and pilot test an ergonomic assessment tool for people with IA and to propose ergonomic modifications to prevent work loss and maintain at-work productivity. Relevant content was identified in a literature review by an interdisciplinary team. Respecting some clients' reluctance to disclose arthritis to employers, no work site visit was required. An initial assessment tool was reviewed by a 4-person expert panel, revised and pretested with 13 adults with IA by 3 occupational therapists (OTs). The final tool, comprised of a self-assessment, an interview guide, and a solutions summary, was used in a pilot test of a multifaceted program designed to prevent work loss and maintain at-work productivity. One OT conducted all ergonomic consultations and followed up with phone calls at 1 month. Implementation of recommendations was evaluated at 3, 6, and 12 months. Nineteen women (mean age 51 years) with IA (mean disease duration 12 years) completed ergonomic assessments. A range of risks were identified and 87 recommendations were made (mean 4.5 per participant). At 1 year, 85% of recommendations had been implemented by 74% of the participants. The Ergonomic Assessment Tool for Arthritis is a feasible and comprehensive process for identifying ergonomic job accommodations.

The Impact of Gout on Work Absence and Productivity

Objectives The goal of this analysis was to evaluate the impact of gout, a painful inflammatory arthritis condition, on an employed population's health-related work absence and objectively measured productivity output. Methods Payroll, demographic, medical, pharmaceutical, sick leave, short- and long-term disability, and workers' compensation data were collected from multiple large employers with employees widely dispersed across the United States. Data were collected during the time period of 2001 to 2004 from approximately 300,000 employees. Objective productivity output data were also available for a subset of employees (captured electronically in the form of units of work processed per person). T-tests and chi-square tests were used to compare demographic data. Two-stage multivariate regression models were used to compare annual work absence and at-work productivity between employees with and without gout, while controlling for group differences indemographics, salary, other work-related variables, and comorbidities (using the Charlson Comorbidity Index). Results The annual prevalence of gout was 4.7 per 1000 employees from 2001 to 2004. Employees with gout had 4.56 more annual absence days for all categories of health-related work absence than those without gout. Objective productivity (units of work processed) results were only available for a small subsample of employees (86 with gout and 27,472 without gout). Employees with gout processed 3.51% fewer units per hour worked and 2.38% fewer units per year than employees without gout (nonsignificant at P = 0.49 and P = 0.78, respectively). Conclusion This study suggests that gout has a substantial impact on work absence and may also negatively impact productivity.

Lost Time, Absence Costs, and Reduced Productivity Output for Employees With Bipolar Disorder

We sought to evaluate the incremental health-related lost work time and at-work productivity loss for employees with bipolar disorder (BPD). Health-related absence and real productivity output of employees with BPD were compared with that of non-BPD and other employee cohorts from a large employer database using multivariate regression to control for cohort differences. After adjusting for confounding factors, employees with BPD had significantly higher absence costs (1,219 dollars) and 11.5 additional lost days (P<0.05) per year than those without BPD. Adjusted annual productivity output was 20% lower for the BPD group (P<0.05). Employees with BPD are less likely to be present for work. When present, their productivity level is similar to that of other employees, but over the course of a year, their absence rates result in significant productivity losses.

Health care use and at-work productivity among employees with mental disorders.

This study examines the differential medical care use and work productivity of employees with and without anxiety and with other mental disorders at a large national firm. A unique aspect of this study is that we integrate medical claims and employer-provided, objective productivity data for the same employees. We find extensive mental health comorbidities among anxious employees. Although medical care use differs considerably among employees having no, one, or several treated mental disorders, in most cases their annual average absenteeism and average at-work productivity performance do not differ. Differences among subgroups are observed for job tenure and maternity claims. We discuss these long-term average productivity findings in relation to other literature encompassing shorter time periods.