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Predicting productivity based on EQ-5D: an explorative study

The European Journal of Health Economics volume 15, pages 465–475 (2014)Cite this article

Abstract

Background

Productivity costs are often ignored in economic evaluations. In order to facilitate productivity cost inclusion, it has been suggested to estimate productivity costs indirectly using quality of life data.

Objective

This study aimed to derive and validate an algorithm for predicting productivity losses on the basis of quality-of-life data using the EQ-5D-3L.

Methods

A large representative sample of the Dutch general public (n = 1,100) was asked in a web-based questionnaire to state their expected level of productivity in terms of absenteeism and presenteeism for multiple EQ-5D health states. Based on these data, two generalized estimating equations (GEE) models were constructed: (1) a model predicting levels of absenteeism and (2) a model predicting presenteeism. The models were validated by comparing model predictions with conventionally measured productivity within a group of low back pain patients.

Results

Predicted absenteeism levels based on EQ-5D health state closely resembled conventionally measured absenteeism levels. Productivity losses related to presenteeism seemed somewhat overestimated by our prediction model. Measured and predicted productivity were moderately but highly significantly correlated.

Conclusions

Overall, it appears possible to make reasonable productivity predictions based on EQ-5D data. Further exploration and validation of prediction algorithms remains necessary, however, especially for presenteeism.

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References

  1. Claxton, K., Walker, S., Palmer, S., Sculpher, M.: Appropriate Perspectives for Health Care Decisions. CHE 2010; CHE Research paper 54 (2010)

  2. Gold, M., Siegel, J., Russell, L., Weinstein, M.: Cost-Effectiveness in Health and Medicine. Oxford University Press, Oxford (1996)

    Google Scholar 

  3. Jonsson, B.: Ten arguments for a societal perspective in the economic evaluation of medical innovations. Eur. J. Health Econ. 10, 357–359 (2009)

    PubMed  Article  Google Scholar 

  4. Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Econ. 6, 511–514 (1997)

    CAS  PubMed  Article  Google Scholar 

  5. Stone, P.W., Chapman, R.H., Sandberg, E.A., et al.: Measuring costs in cost-utility analyses. Variations in the literature. Int. J. Technol. Assess. Health Care 16, 111–124 (2000)

    CAS  PubMed  Article  Google Scholar 

  6. Krol, M., Papenburg, J., Koopmanschap, M., Brouwer, W.: Do productivity costs matter? The impact of including productivity costs on the incremental costs of interventions targeted at depressive disorders. Pharmacoeconomics 29, 601–619 (2011)

    PubMed  Google Scholar 

  7. Koopmanschap, M.A., Rutten, F.F.: The impact of indirect costs on outcomes of health care programs. Health Econ. 3, 385–393 (1994)

    CAS  PubMed  Article  Google Scholar 

  8. Lindholm, L., Lofroth, E., Rosen, M.: Does productivity influence priority setting? A case study from the field of CVD prevention. Cost Eff. Resour. Alloc. 6, 6 (2008)

    PubMed Central  PubMed  Article  Google Scholar 

  9. Williams, A.: Cost-effectiveness analysis: is it ethical? J. Med. Ethics 18, 7–11 (1992)

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  10. Tranmer, J.E., Guerriere, D.N., Ungar, W.J., Coyte, P.C.: Valuing patient and caregiver time: a review of the literature. Pharmacoeconomics 23, 449–459 (2005)

    PubMed  Article  Google Scholar 

  11. Koopmanschap, M., Burdorf, A., Jacob, K., et al.: Measuring productivity changes in economic evaluation: setting the research agenda. Pharmacoeconomics 23, 47–54 (2005)

    PubMed  Article  Google Scholar 

  12. Knies, S., Severens, J.L., Ament, A.J., Evers, S.M.: The transferability of valuing lost productivity across jurisdictions. Differences between national pharmacoeconomic guidelines. Value Health 13, 519–527 (2010)

    PubMed  Article  Google Scholar 

  13. Brouwer, W.B., Meerding, W.J., Lamers, L.M., Severens, J.L.: The relationship between productivity and health-related QOL: an exploration. Pharmacoeconomics 23, 209–218 (2005)

    PubMed  Article  Google Scholar 

  14. Lamers, L.M., Meerding, W.J., Severens, J.L., Brouwer, W.B.: The relationship between productivity and health-related quality of life: an empirical exploration in persons with low back pain. Qual. Life Res. 14, 805–813 (2005)

    PubMed  Article  Google Scholar 

  15. Johannesson, M., Meltzer, D., O’Conor, R.M.: Incorporating future costs in medical cost-effectiveness analysis: implications for the cost-effectiveness of the treatment of hypertension. Med. Decis. Making 17, 382–389 (1997)

    CAS  PubMed  Article  Google Scholar 

  16. Rabin. R., de Charro, F.: EQ-5D: a measure of health status from the EuroQol Group. Ann. Med. 33, 3373–3343 (2001)

    Google Scholar 

  17. Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity losses without absence: measurement validation and empirical evidence. Health Policy 48, 13–27 (1999)

    CAS  PubMed  Article  Google Scholar 

  18. Sloane, N.J.A.: A Library of Orthogonal Arrays; 2011 Available from: http://www2.research.att.com/~njas/oadir/. Accessed June 30, 2011

  19. Dolan, P., Gudex, C., Kind, P., Williams, A.: The time trade-off method: results from a general population study. Health Econ. 5, 141–154 (1996)

    CAS  PubMed  Article  Google Scholar 

  20. van Roijen, L., Essink-Bot, M.L., Koopmanschap, M.A., et al.: Labor and health status in economic evaluation of health care. The health and labor questionnaire. Int. J. Technol. Assess. Health Care 12, 405–415 (1996)

    PubMed  Article  Google Scholar 

  21. Bekkering, G.E., van Tulder, M.W., Hendriks, E.J., et al.: Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy. Phys. Ther. 85, 544–555 (2005)

    PubMed  Google Scholar 

  22. Hoeijenbos, M., Bekkering, T., Lamers, L., et al.: Cost-effectiveness of an active implementation strategy for the Dutch physiotherapy guideline for low back pain. Health Policy 75, 85–98 (2005)

    PubMed  Article  Google Scholar 

  23. Torrance, G.W., Feeny, D., Furlong, W.: Visual analog scales: do they have a role in the measurement of preferences for health states? Med. Decis. Making 21, 329–334 (2001)

    CAS  PubMed  Article  Google Scholar 

  24. Brazier, J., Roberts, J., Tsuchiya, A., Busschbach, J.: A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ. 13(9), 873–884 (2004)

    PubMed  Article  Google Scholar 

  25. Janssen, M.F., Birnie, E., Haagsma, J.A., Bonsel, G.J.: Comparing the standard EQ-5D three-level system with a five-level version. Value Health 11(2), 275–284 (2008)

    PubMed  Article  Google Scholar 

  26. Krabbe, P.F., Tromp, N., Ruers, T.J., van Riel, P.L.: Are patients’ judgments of health status really different from the general population? Health Qual. Life Outcomes 9, 31 (2011)

    PubMed Central  PubMed  Article  Google Scholar 

  27. Zhang, W., Gignac, M.A., Beaton, D., et al.: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J. Rheumatol. 37, 1805–1814 (2010)

    PubMed  Article  Google Scholar 

  28. Weisbrod, B.A.: The valuation of human capital. JPE 69, 425–436 (1961)

    Article  Google Scholar 

  29. Koopmanschap, M.A., van Ineveld, B.M.: Towards a new approach for estimating indirect costs of disease. Soc. Sci. Med. 34, 1005–1010 (1992)

    CAS  PubMed  Article  Google Scholar 

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Acknowledgments

We are grateful to Lucas Goossens and Mark Oppe for their useful comments in conducting this study.

Author information

Affiliations

  1. Department of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    Marieke Krol, Elly Stolk & Werner Brouwer

  2. Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands

    Marieke Krol, Elly Stolk & Werner Brouwer

Authors
  1. Marieke Krol
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  2. Elly Stolk
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  3. Werner Brouwer
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Corresponding author

Correspondence to Marieke Krol.

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Krol, M., Stolk, E. & Brouwer, W. Predicting productivity based on EQ-5D: an explorative study. Eur J Health Econ 15, 465–475 (2014). https://doi.org/10.1007/s10198-013-0487-y

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  • DOI: https://doi.org/10.1007/s10198-013-0487-y

Keywords

  • Productivity costs
  • Indirect costs
  • Prediction models
  • EQ-5D
  • Validity

JEL Classification

  • J17
  • I10