Abstract
Background: Chronic diseases and their treatments may cause symptoms that impair performance but are too mild to affect outcome measures such as absences and workforce exit.
Objective: To assess the effect of type 2 diabetes mellitus on individuals’ productivity when working, absences from work and the value of any lost work time.
Methods: Subjects were identified from claims data and enrolled over the phone. A telephone survey was used to elicit information about productivity at work, absences, diabetes history, comorbidities, job characteristics, employment history, demographics and healthcare utilisation. The sample consisted of 472 employed residents of New York state, USA, of whom, 445 worked at one major US corporation. Of the 472 participants, 78 had type 2 diabetes. All participants agreed to release their claims data for this study; participants with diabetes also consented to the release of clinical records. All data were linked at the individual level.
Tobit regression was used to model work efficiency losses, the total productivity time lost and the value of that time. Absences were modelled using Poisson regression. Productivity was measured using absences from work and work efficiency. Work efficiency was assessed using the Osterhaus model.
Main outcome measures and results: Using the Osterhaus model of work productivity, type 2 diabetes was associated with a reduction in productivity at work. These productivity losses increased with the length of exposure to diabetes. Surprisingly, higher productivity losses among employees with diabetes did not translate into significantly higher productivity costs because the group with diabetes earned less. This likely reflects the prevalence of diabetes in populations. Among salaried people, very few reported working extra hours to make up for reduced productivity. Self-report biases may have been a factor in this finding. Type 2 diabetes was not associated with more frequent absences. Other factors that have strong effects on work efficiency are depression and colds, and job satisfaction.
Conclusions: People with type 2 diabetes appear to experience incremental decrements in work performance that may affect their current and future health and performance. Lower incomes of participants with diabetes suggest that both people with diabetes and their employers bear the cost of any work efficiency losses.
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Notes
Increased screening and changes in diagnostic criteria may have contributed to the rise in prevalence. Yet an actual increase in the existence of the disease is suspected and supported by the rising prevalence of diabetes risk factors (e.g.obesity, sedentary lifestyle), and a decrease in mortality from coronary artery disease.
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Acknowledgements
The Agency for Healthcare Research and Quality funded this work through a dissertation grant (R03 HS09891-01).
David Weimer, Ph.D, of the University of Wisconsin-Madison, Madison, Wisconsin, USA, provided advice regarding the design, methodology and presentation of this work. Sarah Trafton, JD of the University of Rochester, Rochester, New York provided helpful comments on the dissertation that preceded this report. Steve Wittlin, MD opened his practice for subject recruitment.
The authors have provided no information on conflicts of interest directly relevant to the content of this study.
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Lavigne, J.E., Phelps, C.E., Mushlin, A. et al. Reductions in individual work productivity associated with type 2 diabetes mellitus. Pharmacoeconomic 21, 1123–1134 (2003). https://doi.org/10.2165/00019053-200321150-00006
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DOI: https://doi.org/10.2165/00019053-200321150-00006