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Measuring productivity changes in economic evaluation

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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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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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Correspondence to Marc Koopmanschap.

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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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