Skip to main content
SpringerLink
Log in

A Systematic Review of Productivity in Economic Evaluations of Workplace Interventions: A Need for Reporting Criteria?

  • Systematic Review
  • Published:
Applied Health Economics and Health Policy Aims and scope Submit manuscript

Abstract

Background

Rheumatic and musculoskeletal diseases (RMDs) are understood to reduce levels of paid productivity. Productivity, including absenteeism and presenteeism, is arguably an important factor for consideration in economic evaluations of workplace interventions for RMDs (WPI-RMDs). Existing methods available to quantify and value absenteeism and presenteeism are heterogeneous and produce estimates that vary substantially across studies. To date, there has been no systematic summary of the reporting quality of methods used to quantify paid productivity included in economic evaluations of WPI-RMDs.

Objective

The aim of this systematic review was twofold. First, the review was conducted to understand if, and how, the impact of WPI-RMDs on productivity was considered and incorporated in published economic evaluations. Second, we aimed to assess the reporting quality of productivity in published economic evaluations of WPI-RMDs and determine the need for a published set of reporting guidelines for productivity.

Methods

This systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic review published in 2008 that focused on the cost effectiveness of WPIs, with limited information on productivity, was updated from 2007 to July 2018. A global search was conducted using three online databases: MEDLINE (1946 to August 2018, week 2), EMBASE (1974 to 10 July 2018); and EconLit (1886 to July 2018). The studies were double-screened by four independent reviewers. Data extraction was conducted using a bespoke data extraction table.

Results

Twenty-one economic evaluations of WPI-RMDs were identified. All studies evaluated absenteeism, but only five reported on levels of presenteeism. The methods used to identify and measure absenteeism were fairly consistent; however, methods used to identify and measure presenteeism, and value absenteeism and presenteeism, varied across studies. Two studies may have potentially double-counted productivity in their economic evaluations of WPI-RMDs. The results of this systematic review identified key elements potentially useful as a starting point to inform reporting quality guidelines for productivity.

Conclusions

Variation in the methods used to quantify productivity and how it is reported in economic evaluations suggests the need for specific published reporting guidelines for productivity. The development of standardised reporting guidelines for the identification, measurement, and valuation of absenteeism and presenteeism in economic evaluations may help reduce variation in the methods and promote transparency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability statement

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Notes

  1. The NHS EED economic evaluation filter is a standardised and published search strategy that was created by the Centre for Reviews and Dissemination (CRD) to identify economic evaluations.

  2. The PICO framework is a technique used in evidence-based medicine to formulate a patient-specific clinical question and/or review question.

References

  1. Mattke S, Balakrishnan A, Bergamo G, Newberry SJ. A review of methods to measure health-related productivity loss. Am J Manag Care. 2007;13(4):211–7.

    PubMed  Google Scholar 

  2. Jones C, Payne K, Gannon B, Verstappen S. Economic theory and self-reported measures of presenteeism in musculoskeletal disease. Curr Rheumatol Rep. 2016;18:53.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Kigozi J, Jowett S, Lewis M, Barton P, Coast J. The estimation and inclusion of presenteeism costs in applied economic evaluation: a systematic review. Value Health. 2017;20(3):496–506.

    Article  PubMed  Google Scholar 

  4. Loeppke R, Hymel PA, Lofland JH, Pizzi LTH, Konicki DL, Anstadt GW, et al. Health-related workplace productivity measurement: general and migraine-specific recommendations from the ACOEM Expert Panel. J Occup Environ Med. 2003;45(4):349–59.

    Article  PubMed  Google Scholar 

  5. Goetzel RZ, Long SR, Ozminkowski RJ, Hawkins K, Wang S, Lynch W. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. J Occup Environ Med. 2004;46(4):398–412.

    Article  PubMed  Google Scholar 

  6. Parsons SIM. A heavy burden: the occurrence and impact of musculoskeletal conditions in the United Kingdom today. Manchester: Arthritis Research UK Epidemiology Unit; 2011. https://www.escholar.manchester.ac.uk/uk-ac-man-scw:123774?style=librarysearch. Cited 4 May 2017.

  7. Bevan S. Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Pract Res Clin Rheumatol. 2015;29(3):356–73.

    Article  PubMed  Google Scholar 

  8. Health and Safety Executive. Working Days Lost; 2017. http://www.hse.gov.uk/statistics/dayslost.htm. Accessed 13 Dec 2017.

  9. Public Health England. Local action on health inequalities: workplace interventions to improve health and well-being. PHE Publications; 2014. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/355773/Briefing5a_Workplace_interventions_health_inequalities.pdf.

  10. Palmer KT, Harris EC, Linaker C, Barker M, Lawrence W, Cooper C, et al. Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review. Rheumatology. 2012;51(2):230–42.

    Article  PubMed  Google Scholar 

  11. Hemp P. Presenteeism: at work—but out of it. Harvard business review; 2004. https://hbr.org/2004/10/presenteeism-at-work-but-out-of-it. Cited 11 Dec 2014.

  12. Cancelliere C, Cassidy JD, Ammendolia C, Côté P. Are workplace health promotion programs effective at improving presenteeism in workers? a systematic review and best evidence synthesis of the literature. BMC Public Health. 2011;11(1):395.

    Article  PubMed Central  PubMed  Google Scholar 

  13. NICE. Guide to the methods of technology appraisal 2013 | 1-introduction | Guidance and guidelines | NICE; 2013. http://www.nice.org.uk/article/pmg9/chapter/1-introduction. Cited 20 Dec 2014.

  14. NICE. Diagnostics assessment programme. NICE; 2011. https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-diagnostics-guidance. Cited 21 Nov 2018.

  15. Olsen JA, Richardson J. Production gains from health care: what should be included in cost-effectiveness analyses? Soc Sci Med. 1999;49(1):17–26.

    Article  CAS  PubMed  Google Scholar 

  16. Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddard GL, editors. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2015.

    Google Scholar 

  17. Nyman JA. Cost recommendations in the second edition of cost-effectiveness in health and medicine: a review. MDM Policy Pract. 2018;3(1):238146831876516.

    Article  Google Scholar 

  18. Gold MR, Siegel JE, Russell LB, Weinstein MC, editors. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.

    Google Scholar 

  19. Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA. 2016;316(10):1093–103.

    Article  PubMed  Google Scholar 

  20. Hillage J, Rick J, Pilgrim H, Carroll C, Booth A. Evidence review 1: review of the effectiveness and cost effectiveness of interventions, strategies, programmes and policies to reduce the number of employees who move from short-term to long-term sickness absence and to help employees on long-term sickness absence return to work; 2008. http://www.nice.org.uk/nicemedia/pdf/PH19evidenceReview1.pdf. Accessed 15 Aug 2017.

  21. Uegaki K, de Bruijne MC, Lambeek L, Anema JR, van der Beek AJ, van Mechelen W, et al. Economic evaluations of occupational health interventions from a corporate perspective—a systematic review of methodological quality. Scand J Work Environ Health. 2010;36(4):273–88.

    Article  PubMed  Google Scholar 

  22. Moher D, Schulz KF, Simera I, Altman DG. Guidance for developers of health research reporting guidelines. PLoS Med. 2010;7(2):e1000217.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health. 2013;16(2):231–50.

    Article  PubMed  Google Scholar 

  24. Ramsey SD, Willke RJ, Glick H, Reed SD, Augustovski F, Jonsson B, et al. Cost-effectiveness analysis alongside clinical trials II—an ISPOR Good Research Practices Task Force report. Value Health. 2015;18(2):161–72.

    Article  PubMed  Google Scholar 

  25. Nuijten MJC, Pronk MH, Brorens MJA, Hekster YA, Lockefeer JHM, de Smet PAGM, et al. Reporting format for economic evaluation. PharmacoEconomics. 1998;14:259–68.

    Article  CAS  PubMed  Google Scholar 

  26. Petrou S, Gray A. Economic evaluation alongside randomised controlled trials: design, conduct, analysis, and reporting. BMJ. 2011;342:1548.

    Article  Google Scholar 

  27. Centre for Reviews and Dissemination. Systematic reviews: CRD’s guidance for undertaking reviews in health care. 3rd ed. York: Centre for Reviews and Dissemination, University of York; 2009.

    Google Scholar 

  28. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Bernaards CM, Bosmans JE, Hildebrandt VH, van Tulder MW, Heymans MW. The cost-effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on recovery from neck and upper limb symptoms and pain reduction in computer workers. Occup Environ Med. 2011;68(4):265–72.

    Article  PubMed  Google Scholar 

  30. Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J. Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil. 2009;19(1):81–93.

    Article  PubMed  Google Scholar 

  31. Driessen M, Bosmans J, Proper K, Anema J, Bongers P, van der Beek A. The economic evaluation of a participatory ergonomics programme to prevent low back and neck pain. Work Read Mass. 2012;41(Suppl 1):2315–20.

    Google Scholar 

  32. Grahn BEM, Borgquist LA, Ekdahl CS. Rehabilitation benefits highly motivated patients: a six-year prospective cost-effectiveness study. Int J Technol Assess Health Care. 2004;20(2):214–21.

    Article  PubMed  Google Scholar 

  33. Hagen EM, Grasdal A, Eriksen HR. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study. Spine. 2003;28(20):2309–15 (discussion 2316).

    Article  Google Scholar 

  34. Haldorsen EMH, Grasdal AL, Skouen JS, Risa AE, Kronholm K, Ursin H. Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain. Pain. 2002;95(1–2):49–63.

    Article  PubMed  Google Scholar 

  35. Hlobil H, Uegaki K, Staal JB, de Bruyne MC, Smid T, van Mechelen W. Substantial sick-leave costs savings due to a graded activity intervention for workers with non-specific sub-acute low back pain. Eur Spine J. 2007;16(7):919–24.

    Article  PubMed  Google Scholar 

  36. Jensen C, Nielsen CV, Jensen OK, Petersen KD. Cost-effectiveness and cost-benefit analyses of a multidisciplinary intervention compared with a brief intervention to facilitate return to work in sick-listed patients with low back pain. Spine. 2013;38(13):1059–67.

    Article  PubMed  Google Scholar 

  37. Lambeek LC, Bosmans JE, Van Royen BJ, Van Tulder MW, Van Mechelen W, Anema JR. Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial. BMJ. 2010;341:c6414.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Leon L, Jover JA, Candelas G, Lajas C, Vadillo C, Blanco M, et al. Effectiveness of an early cognitive–behavioral treatment in patients with work disability due to musculoskeletal disorders. Arthritis Care Res. 2009;61(7):996–1003.

    Article  Google Scholar 

  39. Meijer EM, Sluiter JK, Heyma A, Sadiraj K, Frings-Dresen MHW. Cost-effectiveness of multidisciplinary treatment in sick-listed patients with upper extremity musculoskeletal disorders: a randomized, controlled trial with one-year follow-up. Int Arch Occup Environ Health. 2006;79(8):654–64.

    Article  PubMed  Google Scholar 

  40. Noben C, van Vilsteren M, Boot C, Steenbeek R, van Schaardenburg D, Anema JR, et al. Economic evaluation of an intervention program with the aim to improve at-work productivity for workers with rheumatoid arthritis. J Occup Health. 2017;59(3):267–79.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Niemistö L, Rissanen P, Sarna S, Lahtinen-Suopanki T, Lindgren K-A, Hurri H. Cost-effectiveness of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain: a prospective randomized trial with 2-year follow-up. Spine. 2005;30(10):1109–15.

    Article  PubMed  Google Scholar 

  42. Phillips CJ, Phillips Nee Buck R, Main CJ, Watson PJ, Davies S, Farr A, et al. The cost effectiveness of NHS physiotherapy support for occupational health (OH) services. BMC Musculoskelet Disord. 2012;13:29.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Roelofs PDDM, Bierma-Zeinstra SMA, van Poppel MNM, van Mechelen W, Koes BW, van Tulder MW. Cost-effectiveness of lumbar supports for home care workers with recurrent low back pain: an economic evaluation alongside a randomized-controlled trial. Spine. 2010;35(26):E1619–26.

    Article  PubMed  Google Scholar 

  44. Schweikert B, Jacobi E, Seitz R, Cziske R, Ehlert A, Knab J, et al. Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain. J Rheumatol. 2006;33(12):2519–26.

    PubMed  Google Scholar 

  45. Speklé EM, Heinrich J, Hoozemans MJ, Blatter BM, van der Beek AJ, van Dieën JH, et al. The cost-effectiveness of the RSI QuickScan intervention programme for computer workers: results of an economic evaluation alongside a randomised controlled trial. BMC Musculoskelet Disord. 2010;11(1):259.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Squires H, Rick J, Carroll C, Hillage J. Cost-effectiveness of interventions to return employees to work following long-term sickness absence due to musculoskeletal disorders. J Public Health Oxf Engl. 2012;34(1):115–24.

    Article  Google Scholar 

  47. Steenstra IA, Anema JR, van Tulder MW, Bongers PM, de Vet HCW, van Mechelen W. Economic evaluation of a multi-stage return to work program for workers on sick-leave due to low back pain. J Occup Rehabil. 2006;16(4):557–78.

    Article  PubMed  Google Scholar 

  48. Tompa E, Dolinschi R, Natale J. Economic evaluation of a participatory ergonomics intervention in a textile plant. Appl Ergon. 2013;44(3):480–7.

    Article  PubMed  Google Scholar 

  49. Torstensen TA, Ljunggren AE, Meen HD, Odland E, Mowinckel P, Geijerstam S. Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up. Spine. 1998;23(23):2616–24.

    Article  CAS  PubMed  Google Scholar 

  50. van den Hout WB. The value of productivity: human-capital versus friction-cost method. Ann Rheum Dis. 2010;69(Suppl 1):i89–91.

    Article  PubMed  Google Scholar 

  51. Koopmanschap MA, van Ineveld BM. Towards a new approach for estimating indirect costs of disease. Soc Sci Med. 1992;34(9):1005–10.

    Article  CAS  PubMed  Google Scholar 

  52. Netherlands S. Jobs (outstanding, new and filled). Centraal Bureau voor de Stastistek; 2012. http://statline.cbs.nl/StatWeb/publication/?VW=T&DM=SLNL&PA=80857NED&LA=NL. Accessed 25 Feb 2019.

  53. Pike J, Grosse SD. Friction cost estimates of productivity costs in cost-of-illness studies in comparison with human capital estimates: a review. Appl Health Econ Health Policy. 2018;16(6):765–78.

    Article  PubMed Central  PubMed  Google Scholar 

  54. EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.

    Article  Google Scholar 

  55. Braakman-Jansen LM, Taal E, Kuper IH, van de Laar MA. Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA. Rheumatology (Oxford). 2012;51(2):354–61.

    Article  Google Scholar 

  56. Johns G. Presenteeism in the workplace: a review and research agenda. J Organ Behav. 2010;31(4):519–42.

    Article  Google Scholar 

  57. Brooks A, Hagen SE, Sathyanarayanan S, Schultz AB, Edington DW. Presenteeism: critical issues. J Occup Environ Med. 2010;52(11):1055–67.

    Article  PubMed  Google Scholar 

  58. International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Pharmacoeconomic guidelines around the world. https://www.ispor.org/PEguidelines/index.asp. Cited 23 May 2017.

  59. Brazier J, Tsuchiya A. Improving cross-sector comparisons: going beyond the health-related QALY. Appl Health Econ Health Policy. 2015;13(6):557–65.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Al Maini M, Adelowo F, Al Saleh J, Al Weshahi Y, Burmester GR, Cutolo M, et al. The global challenges and opportunities in the practice of rheumatology: white paper by the World Forum on Rheumatic and Musculoskeletal Diseases. Clin Rheumatol. 2015;34(5):819–29.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Professor David Coggon and Professor Karen Walker-Bone from the Centre for Musculoskeletal Health and Work, Southampton, for providing their feedback and comments. They would also like to thank Peslie Ng’ambi for double screening the studies identified.

Author information

Authors and Affiliations

  1. Manchester Centre for Health Economics, The University of Manchester, 4.306, Jean McFarlane Building, Manchester, M13 9PL, UK

    Cheryl Jones & Katherine Payne

  2. Arthritis Research UK-MRC Centre for Musculoskeletal Health and Work, The University of Southampton, Southampton, UK

    Cheryl Jones

  3. Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

    Suzanne M. M. Verstappen

  4. NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

    Suzanne M. M. Verstappen

Authors
  1. Cheryl Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suzanne M. M. Verstappen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katherine Payne
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Cheryl Jones created the search strategy, conducted the search, screened the titles and abstracts of all identified studies from the search, identified relevant full-text articles, extracted the data of the relevant studies, wrote the manuscript, and contributed towards the idea for the systematic review. Suzanne Verstappen screened the titles and abstracts of all relevant studies identified by the search, contributed towards the motivation for conducting the review, and provided comments on previous draft versions of the manuscript. Katherine Payne screened the titles and abstracts of all relevant studies identified by the search, made the final decision to include or exclude studies where discrepancies arose, made a significant contribution towards the idea and motivation for conducting the systematic review, and provided substantial comments on previous draft versions of the manuscript.

Corresponding author

Correspondence to Cheryl Jones.

Ethics declarations

Funding sources

This work was supported by Arthritis Research UK and the Medical Research Council (20665).

Ethical approval

Not required.

Conflict of interest

Cheryl Jones, Suzanne Verstappen and Katherine Payne declare that they have no conflicts of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 21 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jones, C., Verstappen, S.M.M. & Payne, K. A Systematic Review of Productivity in Economic Evaluations of Workplace Interventions: A Need for Reporting Criteria?. Appl Health Econ Health Policy 17, 591–613 (2019). https://doi.org/10.1007/s40258-019-00473-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40258-019-00473-8

Search

Navigation