Worker Productivity | Cholesterol Evaluation Measures

Worker productivity measures for cholesterol screening and control1-9

Healthier employees are less likely to call in sick. Employees with multiple heart disease and stroke risk factors such as high cholesterol and high blood pressure cost employers more in terms of medical care, absenteeism, and lost productivity than employees with one or none of these risk factors. Companies can sometimes assess sick day use to determine whether health programs are increasing worker productivity.

Baseline

  • Individuals with high cholesterol may be absent more often than individuals with normal cholesterol or those who have their cholesterol under control (e.g., with medication). Measure the average number of sick days for individuals with high cholesterol, over the previous 12 months
  • High blood cholesterol can cause heart disease. Companies can measure the average number of sick days related to the complications of high cholesterol such as to heart disease, per employee, over the previous 12 months. For example: 
    • What are the average number of sick days due to diagnosed heart attack (total number of sick days due to heart attack divided by total number of employees)
    • This measure may be less useful if there has been a large increase or decrease in numbers of employees over the past 12 months
    • It may take years for elevated blood cholesterol levels to lead to heart disease or heart attack, so measuring sick days to assess the productivity effects of this condition is less satisfactory than for other conditions described in this toolkit. Health care costs measures are probably a better indication of the impact of this condition on the company’s cost
  • Determine costs for worker absenteeism related to high cholesterol and its the complications such as heart disease, including costs of replacement workers, costs in training replacement workers, and lost and delay in productivity
  • Determine the time employees spend during working hours participating in worksite cholesterol screening and control programs or lifestyle programs that can control or reduce high cholesterol such as physical activity, nutrition, tobacco use, and obesity
  • Additional validated surveys have been developed to provide employers with information about the indirect costs of untreated or undertreated employee health issues such as high cholesterol. Employers who use these health and productivity surveys on an ongoing basis can begin to evaluate the return on investment (ROI) of offering cholesterol screening and control programs on employee absence or productivity. These surveys may be proprietary and may require a modest fee to use. Two examples are provided below: 
    • Health and Work Performance Questionnaire (HPQ)external icon is a short, easy to administer self-report survey designed to estimate workplace indirect costs (absenteeism, reduced productivity, and injury due to accidents) of employee health problems developed by the World Health Organization (WHO) and the Harvard Medical School
    • The Work Limitations Questionnaire (WLQ)external icon developed by the Health Institute at Tufts Medical Center is an easy to use questionnaire that addresses general work limitations which can be built into other health assessment tools such as a health risk appraisal or employee health survey

Process

  • Re-assess the average number of sick days for high cholesterol and its complications per employee at the first follow-up evaluation◦If employee education programs are successful, these measures may increase in the short term as screening and detection rates increase
  • Periodic repeats of other baseline measures

Outcome

  • Assess changes in the average number of sick days for high cholesterol and its complications per employee in repeated follow-up evaluations
  • Assess changes in the time employees spend during working hours participating in worksite cholesterol screening and control programs or lifestyle programs that can control or reduce high cholesterol
  • Assess changes in costs from baseline
References

1.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

2.  Matson Koffman DM, Goetzel RZ, Anwuri VV, Shore K, Orenstein D, LaPier T. Heart-healthy and stroke-free: successful business strategies to prevent cardiovascular disease. Am J Prev Med. 2005; 29(5), suppl. 1:113-121.

3.  Goetzel RZ, Anderson DR, Whitmer RW, Ozminkowski RJ, Dunn RL, Wasserman J; Health Enhancement Research Organization (HERO) Research Committee. The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database. J Occup Environ Med. 1998 Oct;40(10):843-854.

4.  Tsai SP, Wendt JK, Ahmed FS, Donnelly RP, Strawmyer TR. Illness absence patterns among employees in a petrochemical facility: impact of selected health risk factors. J Occup Environ Med. 2005 Aug;47(8):838-846

5.  Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, Pronk N, Simon G, Stang P, Ustun TB, Wang P. The World Health Organization Health and Work Performance Questionnaire (HPQ). J Occup Environ Med. 2003 Feb;45(2):156-174.

6.  Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, Stang PE, Ustun TB. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004 Jun;46(6 Suppl):S23-37.

7.  Wang PS, Beck A, Berglund P, Leutzinger JA, Pronk N, Richling D, Schenk TW, Simon G, Stang P, Ustun TB, Kessler RC. Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys. J Occup Environ Med. 2003 Dec;45(12):1303-1311.

8.  Lerner D, Amick BC 3rd, Rogers WH, Malspeis S, Bungay K, Cynn D. The Work Limitations Questionnaire. Med Care. 2001 Jan;39(1):72-85.

9.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.