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Presenteeism and the Value of Productivity Instruments NASA Presenteeism and the Value of
Productivity Instruments
NASA
December 1, 2005 Todays Agenda
Welcome & Introductions
Presenteeism and its Role in Population Health Management
What is presenteeism?
Where does it fit in the big picture?
Why should we be concerned about it?
How is presenteeism being measured?
What can you do to improve presenteeism through your worksite
Case Study Examples
Questions & Answers Presenteeism;
Role in Population Health Management
What is presenteeism?
The measurable extent to which health
symptoms, conditions and diseases adversely
affect the work productivity of individuals
who choose to remain at work.
Larry Chapman, The Art of Health Promotion 2005 Where does it fit within the Big Picture?
Presenteeism is a type of need that a program can
address. Presenteeism shows up as a need that can be measured and
targeted through interventions as well as a estimating a total
outcome of Population Health Management.
Presenteeism should be measured in order to be managed
and re-measured in order to document improvements
associated with interventions and changes in intermediate
effects. Conceptual Model of H&P Management
Health Risks
Policy Change
Education
Plan Design Change
Individual
intervention
Incentives
Administrative
Change
Cultural Changes
Economic Return
Health plan costs
Sick leave costs
Workerscomp costs
Disability costs
Presenteeism
Non-Economic Return
Decision quality
Stamina & Resilience
Inter-personal skills
Positive attitude
Strength & flexibility
Company loyalty
Morale
Recruitment
Retention
Turnover
Injury risks
Chronic
Illness
Disabilities
Absenteeism
Medical
Costs
Presenteeism
More
Productive
Employees
Healthier
People
Behavior
Change
Summex, L. AJHP. 2005 March-April;19(4):1-8 Why should we be concerned about it?
1.
Increased aging in the US workforce
2.
Greater awareness of problem of productivity loss
3.
Improvements in the measurement methodology of
presenteeism
4.
Increased pharmaceutical industry interest and
support
5.
Growing competitive pressures in many market
sectors
6.
Logical out-growth of worksite health promotion
programming
Summex, L. AJHP. 2005 March-April;19(4):1-8 Lost Productivity Presenteeism
Presenteeism - At work, but not feeling well.
Migraine Headache Total cost U.S. $12B, 60-70% lost
productivity
Burton - JOEM 2004
Allergies
U.S.$2.8B lost productivity - 90% Presenteeism,
10% Absenteeism
Burton - JOEM 2004 $2,098
$4,530
$5,813
$7,123
$4,401
$3,216
$1,550
$2,667
$3,364
$4,718
$3,069
$2,480
$1,351
$2,110
$2,912
$3,894
$2,605
$2,200
$1,122
$1,523
$2,081
$2,941
$1,851
$1,641
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
19-34
35-44
45-54
55-64
65-74 75+
Costs
Associated with Risks
Associated with Risks
Medical Paid
Medical Paid Amount
x Age x Risk
x Age x Risk
Low Risk
Medium Risk
High Risk
Non --Participant
Edington, D. W. Emerging Research. AJHP. 2001:15(5):341-349. Health Risks and Behaviors X hours Lost
0
2
4
6
8
Cur
rent
Sm
oker
s
Phy
sica
l Ac
tivit
ies (
<1/w
k)
Seat
belt
Usa
ge (<9
0%)
Enc
ount
ered
Vio
lent
Eve
nts
Dist
ress
Hig
h Bl
ood
Pres
sure
Cho
leste
rol
BM
I at
risk
0-1
Risk
Fac
tors
2 R
isk F
acto
rs
3+ R
isk F
acto
rs
Illness
STD
Presenteeism
Burton,Conti,Chen,Schultz,Edington.1999 JOEM.41,863-877. Disease States X Hours Lost
0
2
4
6
8
10
12
14
16
w/M
enta
l He
alth

w/R
espi
rato
ry
w/In
jury

w/D
iges
tive

w/M
uscu
losk
eleta
l
w/D
iabe
tes
w/C
ance
r
W/O
ther

Illness
STD
Presenteeism
Burton,Conti,Chen,Schultz,Edington.1999 JOEM.41,863-877. Top Ten Most Costly Health Conditions
Condition Rank
Total
Cost
Using Average Presenteeism
Estimate per ee/per year
Percent of Total
Expenditure due to
Presenteeism
Hypertension 1
$
392.31
9%
Heart Disease
2
$ 368.34
0%
Depression
3
$ 348.04
27%
Arthritis
4
$ 326.88
35%
Allergies
5
$ 271.04
55%
Diabetes
6
$ 256.91
16%
Migraines
7
$ 213.78
49%
Cancer
8
$ 144.01
6%
Respiratory infections
9
$ 133.84
3%
Asthma
10
$ 99.55
35%
Goetzel, R.,. JOEM, 45(1):5-14. 2003 How is presenteeism being
measured?
There are a large number of work productivity loss
instruments that have been reviewed, validated and
reported in the research literature.
Measuring Employee Productivity by Wendy Lynch and
John Reidel
American Journal of Health Promotion
Journal of Occupational & Environmental Medicine Survey Instrument
Question Set
Comments
American Productivity Audit (APA)
46 questions
Measures absenteeism &
presenteeism
Endicott Work Productivity Scale
25 self-scored
questionnaire
Captures absenteeism &
presenteeism
Health and Labor Questionnaire
(HLQ
)
7 presenteeism
question plus 3
additional
domains
Measures absenteeism &
presenteeism, unpaid production
and work impediments
Stanford Presenteeism Scale
(SPS)
6 questions/
Likert scale
Captures presenteeism
Work Limitations Questionnaire (
WLQ)
25 questions
Captures presenteeism
Work Productivity & Activity
Impairment Questionnaire
(WPAI)
6 questions
Captures absenteeism &
presenteeism
Work Productivity Short Inventory
(WPSI)
66 questions at
maximum
Captures absenteeism and
presenteeism & caregiver demands
HPQ
30 questions
Captures absenteeism and
presenteeism Characteristics of the tools
Average 15-30 questions
Average 20 minutes
Telephone, Paper/Pen, Web-based
Some ask questions about particular diseases and some are more
general but can be used in either type of application
Recall periods vary from 1 week to 1 year, but most used recall
periods closer to the short end of the range
Nearly all instruments were designed for employed adults
Instruments vary in terms of reliability and validity and this
information can be obtained from their others Example WLQ provides 3 levels
Individual item responses provide information about
limitations performing specific job tasks
Intermediate level four scale scores ability to address
the jobs
Physical demands
Time management demands
Mental and interpersonal demands
Output demands
Summary level
Productivity loss index which is interpreted as the percentage
of output lost/hour due to presenteeism compared to a non-
limited employee benchmark group Example - HPQ -
Four Dimension are Sickness Absence, Quantity of Work, Quality of
Work, Interpersonal Relations at Work
Survey data can be used to put a monetary value on the indirect
cost of lost productivity due to health conditions and the
productivity gain that is achieved through treatment.
The instrument allows employers to measure how much
productivity loss is due to specific health conditions and to
configure health benefits to meet the needs of employees.
Pharmaceutical companies may use it to measure the effects of
new drugs or treatments on work Work Productivity and Activity Impairment Questionnaire (WPAI)
General Health (GH), Self-Administration Version
The following questions ask about the effect of your health problems on your ability to work and
perform regular activities. By health problems we mean any physical or emotional problem or
symptom. Please fill in the blanks or circle a number, as indicated.
1. Are you currently employed (working for pay)? _ _ _ _ _ _ _ _No _ _ _ _ _ _ _Yes
If NO, check "NO" and skip to question 6.
The next questions refer to the past seven days, not including today.
2. During the past seven days, how many hours did you miss from work because of your health
problems? Include hours you missed on sick days, times you went in late, left early etc., because of
your health problems. Do not include time you missed to participate in this study.
_ _ _ _ _ _ _ _ _ _Hours
3. During the past seven days, how many hours did you miss from work because of any other reason,
such as vacation, holidays, time off to participate in this study? _ _ _ _ _ _ _ _ _ _Hours 4. During the past seven days, how many hours did you actually work?
_ _ _ _ _ _ _ _ _ _Hours (If "0", Q.6)
5. During the past seven days, how much did your health problems affect your productivity while you
were working? Think about days you were limited in the amount or kind of work you could do,
days you accomplished less than you would like, or days you could not do your work as carefully
as usual. If health problems affected your work only a little, choose a low number. Choose a high
number if health problems affected your work a great deal.
Health problems had
0 1 2 3 4 5 6 7 8 9 10
Health problems completed
no effect on my work
prevented me from working
6. During the past seven days, how much did your health problems affect your ability to do your
regular daily activities, (other than work at a job)?
By regular activities, we mean the usual activities
you do, such as work around the house, shopping, child care, exercising, studying, etc. Think about times you
were limited in the amount or kind of activities you could do and times you accomplished less than you would
like. If health problems affected your