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Better tools needed to measure presenteeism
Advocate for positive changes
More reliable tools are needed to measure the costs of presenteeism, which takes an insidious toll on the work place.1
"We were struck by the variation in results by other researchers using different self-report tools," reports Dee W. Edington, PhD, director of the University of Michigan's Health Management Research Center in Ann Arbor, MI. "That concern led us to examine the sources of the variation."
Edington says that he was surprised to find "disturbing issues" at each level of analyses: measurement, conversion from measurement to a unit of presenteeism, and translation of presenteeism to a financial unit.
"It would benefit researchers and health professionals if there were more transparency, common metrics between instruments, and increased reliability and validity," says Edington.
According to Edington, your best option is to use a company-generated performance scale. "If the company does not have a measure, then I would use any of the current self-reported measurement scales," he says. "However, I would be cautious about quantification, since we don't know the truth at this time."
In general, those individuals with more risk factors or with a disease have more lost time at work, says Edington. "We have also shown that when risk factors change, presenteeism changes in the same direction," he adds.
More than medical costs
Presenteeism costs are estimated to be greater than the cost of absenteeism, and represent up to 60% of all costs of mental and physical illnesses, notes Diane Lack, RN, MS, CCM, cardiology case manager at the University of Michigan Health System's Cardiovascular Center in Ann Arbor.
"Costs related to presenteeism are greater than the direct health costs for ten of the most costly health conditions studied and accounted for 18 to 60% of all health care costs," says Lack.
Lack says that employers do not fully consider the fact that expenses related to presenteeism losses are, for the most part, greater than actual medical costs.
"Presenteeism impacts individuals and organizations, affecting quality of life and health," says Lack. "It leads to increased health care costs, increases in occupational accidents related to distractibility, and deterioration of service and product quality."
Lack says that there is an opportunity for occupational health nurses to determine the significance of presenteeism, and its effect on the physical and psychosocial well-being of individual workers.
Obtain information through careful measurement of presenteeism using the appropriate tools, she says, and use this to develop interventions. Here are Lack's recommendations:
Target wellness and disease management programs to the specific needs identified.
Your goal should be "increased health and health maintenance," says Lack.
Be a strong advocate for positive changes in workplace policies.
"Promote flexibility for workers providing dependent care and for the special needs of aging workers, and provision of appropriate health care," says Lack. Another important goal, she says, is to "strive for mental health destigmatization, and recognition and treatment for mental health disorders and stress reduction."
Implement a work culture that promotes self-care and rest.
"This minimizes exacerbation of symptoms, and prevents the spread of illness to co-workers," says Lack.
Invest in wellness.
"Declines in productivity related to presenteeism could be offset by small investments in screening, education, and treatment," says Lack. "Studies do show that, globally, the return on investment for wellness programs is increasing." (See related story on use of data to measure productivity, below.)
1. Brooks A, Hagen SE, Sathyanarayanan S, et al. Presenteeism: critical issues. J Occup Environ Med. 2010; 52(11):1055-1067.
For more information on measuring presenteeism, contact:
Dee W. Edington, PhD, Director, University of Michigan, Health Management Research Center, Ann Arbor, MI. Phone: (734) 647-7602. Fax: (734) 763-2206. E-mail: firstname.lastname@example.org
Diane Lack, RN, MS, CCM, Cardiology Case Manager, Cardiovascular Center University of Michigan Health System, Ann Arbor. Phone: (734) 647-7321. Fax: (734) 232-4480. E-mail: email@example.com.