Abstract
Productivity costs related to illness may be relevant in assessing healthcare programmes for patients, as well as occupational interventions for workers. When performing an economic evaluation for both types of programmes, a sound methodology for measuring and valuing these productivity costs is essential. This article reviews research questions related to productivity and health, focusing on the costs of short-term absence from work, productivity costs without absence (‘presenteeism’) and possible compensation mechanisms and circumstances that may affect productivity costs. Furthermore, the important but under-explored relationship between productivity and QOL is analysed.
Strategies for better answers on these research questions, such as developing more valid measurement instruments, are discussed. It is stressed that the analysis of productivity costs should not be restricted to the level of the individual patient and worker but extended to the level of teams of workers and firms. It may be advisable to explore several issues such as compensation mechanisms and efficiency losses in detail using employee questionnaires and consecutively applying the key elements in patient settings. It seems advisable to develop flexible, modular instruments for measuring and valuing absence from work, compensation mechanisms, efficiency loss and details of jobs and organisation in an integrative and consistent way. Further, it seems crucial to identify what determinants of jobs and organisations are the key factors in estimating productivity costs. This list of determinants could be mapped with a classification of jobs, to be used as a screener in patient questionnaires.
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References
Ten years of working conditions in the European Union. Dublin: European Foundation, 2001
Brouwer WBF, Schut FT. Priority care for employees: a blessing in disguise? Health Econ 1999 Feb; 8 (1): 65–73
Guidelines for economic evaluation of pharmaceuticals. 2nd ed. Ottawa (ON): Canadian Coordinating Office for Health Technology Assessment (CCOHTA), 1997
Guidelines for the pharmaceutical industry on preparation of submission to the pharmaceutical Benefits Advisory Committee. Canberra: Commonwealth Department of Human Services, 1995
Riteco JA, De Heij LJM, van Luijn JCF, et al. Dutch guidelines: pharmacoeconomic research guidelines. Amstelveen: CvZ, 1999
Johanneson M, Meltzer D. Some reflections on cost-effectiveness analysis. Health Econ 1998 Feb; 7 (1): 1–7
Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 15: 171–89
Koopmanschap MA, van Ineveld BM. Towards a new approach for estimating indirect costs of disease. Soc Sci Med 1992; 34 (9): 1005–10
Borghouts JAJ, Koes BW, Vondeling H, et al. Cost-of-illness of neck pain in The Netherlands in 1996. Pain 1999; 80: 629–36
Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain 2000; 84: 95–103
Boonen A, van der Heijde D, Landewe R, et al. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Ann Rheum Dis 2002; 61: 429–37
Gold MR, Siegel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. Oxford: Oxford University Press, 1996
Brouwer WBF, Koopmanschap MA, Rutten FFIL Productivity costs measurement through QOL? A response to the recommendation of the Washington panel. Health Econ 1997; 6: 253–9
Brouwer WBF, Koopmanschap MA, Rutten FFIL Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Econ 1997; 6: 511–4
Pauly MV, Nicholson S, Xu J, et al. A general model of the impact of absenteeism on employers and employees. Health Econ 2002; 11: 221–31
Sculpher M. The role and estimation of productivity costs in economic evaluation. In: Drummond MF, McGuire A, editors. Economic evaluation in health care: merging theory with practice. Oxford: Oxford University Press, 2001
Severens JL, Laheij RJF, Jansen JBMJ, et al. Estimating the cost of lost productivity in dyspepsia. Aliment Pharmacol Ther 1998; 12: 919–23
Brouwer WBF, Koopmanschap MA, Rutten FFIL Productivity costs before and after absence from work: as important as common? Health Policy 2002; 61: 173–87
Brouwer WBF, Koopmanschap MA, Rutten FFIL Productivity losses without absence: measurement validation and empirical evidence. Health Policy 1999; 48: 13–27
Van Roijen L, Essink-Bot ML, Koopmanschap MA, et al. Labour and health status in economic evaluation of health care: the health and labour questionnaire. Int J Technol Assess Health Care 1996; 12: 405–15
Hagberg M, Wigaeus-Torngvist E, Toomingas A. Self-report reduced productivity due to musculoskeletal symptoms: associations with workplace and individual factors among whitecollar computer users. J Occup Rehabil 2002; 12: 151–62
Brouwer WBF, Koopmanschap MA. How to calculate indirect costs in economic evaluations. Pharmacoeconomics 1998; 13 (5 Pt 1): 563–9
Berger ML, Murray JF, Xu J, et al. Alternative valuations of work loss and productivity. J Occup Environ Med 2001; 43 (1): 18–24
Severens JL, Mulder J, Laheij RJF, et al. Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands. Soc Sci Med 2000; 51: 243–9
Severens JL, Mulder J, Laheij RJF, et al. Validity of measuring compensation mechanisms for absence from work as a basis for calculating productivity costs. 15th Annual International Society of Technology Assessment in Healthcare (ISTAHC) Meeting; June 1999, Edinburgh
Koopmanschap MA, Rutten FFIL van Ineveld BM, et al. Reply to Johannesson’s and Karlsson’s comment. J Health Econ 1997; 16: 257–9
Lamers LM, Meerding WY, Severen JL et al. The relationship between productivity and health related QOL: a empirical exploration in persons with low back pain. QOL Research. In press
Osterhaus IT, Gutterman DL, Plachetka JR. Health care resource and lost labour costs of migraine headache in the US. Pharmacoeconomics 1992; 2: 67–76
Lerner D, Amick BC, Rogers WH, et al. The work limitations questionnaire. Med Care 2001; 39 (1): 72–85
Acknowledgements
The authors gratefully acknowledge the financial support of The Netherlands Organisation for Health Research and Development (ZONMW) for scientific research in health services (subsidy 945-10-041/46). Each author participated in the preparatory discussions for this review and commented on several versions. The authors have no conflicts of interest directly relevant to the content of this review.
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Koopmanschap, M., Burdorf, A., Jacob, K. et al. Measuring productivity changes in economic evaluation. Pharmacoeconomics 23, 47–54 (2005). https://doi.org/10.2165/00019053-200523010-00004
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DOI: https://doi.org/10.2165/00019053-200523010-00004