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Objective: To estimate indirect costs associated with rheumatoid arthritis (RA)., Methods: This was a retrospective study using 1996-2006 US Medical Expenditure Panel Survey data. Employed individuals were aged 18 to 65 years. A two-part model estimated the probability of time lost from work and annual number of workdays missed due to illness., Results: Sixty-seven percent (209/312) of RA individuals missed work versus 58% (52,046/89,734) of those without RA (P = 0.0007). Among individuals who missed work, those with RA missed more workdays annually than those without RA ((Equation is included in full-text article.)= 13.659, 9.879, respectively; P = 0.008). Incremental per capita costs in annual lost workdays between those with and without RA were $596. Estimated national indirect costs of RA-related absenteeism were $252 million annually., Conclusions: Individuals with RA have higher probabilities of missing work and missing workdays than those without RA.

Objective: To estimate indirect costs associated with inflammatory bowel disease (IBD)., Methods: This was a retrospective study using 1996 to 2006 US Medical Expenditure Panel Survey data. Employed individuals were aged 18 to 64 years. A two-part model estimated the probability of time lost from work because of illness and the annual number of workdays missed., Results: A total of 71.5% (143/200) and 58.2% (52,257/89,846) of individuals with and without IBD, respectively, missed time from work because of illness (P = 0.0001). Among individuals who missed work, those with IBD missed more workdays annually than those without IBD ((Equation is included in full-text article.)= 13.38, 9.89, respectively; P = 0.044). Incremental per capita cost in annual lost workdays between those with and without IBD was $783. National indirect IBD-related costs were $249 million annually., Conclusions: Individuals with IBD have higher probabilities of missing time from work and missing workdays than those without IBD.

Objective: We conducted this study to determine whether topiramate at 100 mg/d for the treatment of migraine headache is associated with improved productivity in the workplace., Methods: Results were derived from two randomized, double-blind, placebo-controlled trials among migraineurs. The number of hours of absenteeism (A), presenteeism (P), and total lost productivity (TLP) (A + P) were calculated. Results were not adjusted for multiplicity., Results: A total of 325 (162 in the topiramate group and 163 in the placebo group) of 449 subjects were included. Per person mean monthly A rate was only significantly less for individuals within the topiramate group (1.0 hours per person) versus those in the placebo group (1.5 hours per person) for month 3 (P < 0.05). Per person mean P and TLP rates were significantly lower for individuals in the topiramate group versus those in the placebo group for months 1 through 5 (P < 0.05)., Conclusions: Findings suggest that topiramate, compared with placebo, is associated with decreased workplace presenteeism and TLP.

Objectives: (1) To examine the relationship between access to care and the number of missed workdays, and (2) to determine how this relationship is confounded by the presence of having health insurance and health care use among migraineurs., Design/methods: This retrospective, pooled, cross-sectional study used 1996 to 1999 Medical Expenditure Panel Survey data. Employed migraineurs who were between 18 and 65 years of age were included. Individuals reporting a neoplastic or an acute pain condition were excluded. An access to care index was developed using Rasch Partial Credit Analysis. A 2-part model was used to estimate the annual number of missed workdays., Results: Of the 703 migraineurs, 538 (77%) reported missing work time. Of those who missed work, the mean (SE) annual number of missed workdays was 4.4 (.39). A higher level of access to care (P= .025) and presence of depression (P= .033) were significantly associated with missing a greater number of workdays. We created a proxy for migraine severity based on migraine-related prophylactic medication use and hospitalization(s). Severe migraines were significantly (OR = 2.01, SE = .51, P= .006) associated with an increased likelihood to miss workdays. When health insurance was included in the model, a higher level of access to care was significantly associated with the increased likelihood to miss workdays (OR = 1.04, SE = .021, P= .05). From the original model, the odds ratio (1.035 to 1.040) and the SE (.020 to .021) increased slightly. When health care use was included in the model and health insurance was removed, (1) emergency department visits were significantly (P= .006) associated with missing a greater number of workdays, and (2) access to care was significantly associated with missing a greater number of workdays (P= .028). When having health insurance and health care use were simultaneously included in the model, a higher level of access to care was significantly associated with greater likelihood to miss work (OR = 1.040, SE = .0212, P= .05) and missing a greater number of workdays (P= .005). However, a change of 1 standard deviation in the score would be associated with a 12% change in the odds to miss work and only 8 percentage points change in the number of missed workdays., Conclusions: Contrary to expectations, a higher level of access to care is significantly associated with an increased likelihood to miss work and with missing a greater number of workdays. Depression, migraine severity, and health care use are important explanatory variables. Having health insurance may be a confounder between access to care and workplace absenteeism.

Objectives: The objectives of this study were to examine the relationship between health insurance (HI) and number of missed workdays (MW), and how it is modified by level of access to care (AC) and healthcare use (HC)., Methods: The authors conducted a retrospective study of 1996-1999 Medical Expenditure Panel Survey of U.S. employees., Results: Of 25,676 individuals, 13,957 (54%) reported MW (mean [standard deviation] = 4.3 [0.092]). Having HI was significantly associated with decreased likelihood of MW. Higher level of AC was significantly associated with greater number of MW. HC was significantly associated with increased likelihood of and greater number of MW., Conclusions: Having HI any time over the year is significantly associated with decreased likelihood of and smaller number of MW. HC use is an important explanatory variable and appears to be a confounder between HI and MW. The benefits to employers of ensuring that employees have health coverage should be explored.

The objective of this review was to identify health-related workplace productivity loss survey instruments, with particular emphasis on those that capture a metric suitable for direct translation into a monetary figure. A literature search using Medline, HealthSTAR, PsycINFO and Econlit databases between 1966 and 2002, and a telephone-administered survey of business leaders and researchers, were conducted to identify health-related workplace productivity measurement survey instruments. This review was conducted from the societal perspective. Each identified instrument was reviewed for the following: (i). reliability; (ii). content validity; (iii). construct validity; (iv). criterion validity; (v). productivity metric(s); (vi). instrument scoring technique; (vii). suitability for direct translation into a monetary figure; (viii). number of items; (ix). mode(s) of administration; and (x). disease state(s) in which it had been tested. Reliability and validity testing have been performed for 8 of the 11 identified surveys. Of the 11 instruments identified, six captured metrics that are suitable for direct translation into a monetary figure. Of those six, one instrument measured absenteeism, while the other five measured both absenteeism and presenteeism. All of the identified instruments except for one were available as paper, self-administered questionnaires and many were available in languages other than English. This review provides a comprehensive overview of the published, peer-reviewed survey instruments available to measure health-related workplace productivity loss. As the field of productivity measurement matures, tools may be developed that will allow researchers to accurately calculate lost productivity costs when performing cost-effectiveness and cost-benefit analyses. Using data captured by these instruments, society and healthcare decision makers will be able to make better informed decisions concerning the value of the medications, disease management and health promotion programmes that individuals receive.