Cocker, F and Nicholson, JM and Graves, N and Oldenburg, B and Palmer, AJ and Martin, A and Scott, J and Venn, A and Sanderson, K, Depression in working adults: comparing the costs and health outcomes of working when ill, PLoS One, 9, (9) Article e105430. ISSN 1932-6203 (2014) [Refereed Article]
Copyright 2014 the Authors-This article is distributed under the terms of the Ceative Commons Attribution 3.0 Australia license. (CC BY 3.0 AU).
Official URL: http://www.plosone.org/
Objective: Working through a depressive illness can improve mental health but also carries risks and costs from reduced concentration, fatigue, and poor on-the-job performance. However, evidence-based recommendations for managing work attendance decisions, which benefit individuals and employers, are lacking. Therefore, this study has compared the costs and health outcomes of short-term absenteeism versus working while ill ("presenteeism") amongst employed Australians reporting lifetime major depression.
Methods: Cohort simulation using state-transition Markov models simulated movement of a hypothetical cohort of workers, reporting lifetime major depression, between health states over one- and five-years according to probabilities derived from a quality epidemiological data source and existing clinical literature. Model outcomes were health service and employment-related costs, and quality-adjusted-life-years (QALYs), captured for absenteeism relative to presenteeism, and stratified by occupation (blue versus white-collar).
Results: Per employee with depression, absenteeism produced higher mean costs than presenteeism over one- and five-years ($42,573/5-years for absenteeism, $37,791/5-years for presenteeism). However, overlapping confidence intervals rendered differences non-significant. Employment-related costs (lost productive time, job turnover), and antidepressant medication and service use costs of absenteeism and presenteeism were significantly higher for white-collar workers. Health outcomes differed for absenteeism versus presenteeism amongst white-collar workers only.
Conclusions: Costs and health outcomes for absenteeism and presenteeism were not significantly different; service use costs excepted. Significant variation by occupation type was identified. These findings provide the first occupation-specific cost evidence which can be used by clinicians, employees, and employers to review their management of depression-related work attendance, and may suggest encouraging employees to continue working is warranted.
|Item Type:||Refereed Article|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Psychiatry (incl. Psychotherapy)|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Mental Health|
|UTAS Author:||Cocker, F (Dr Fiona Cocker)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|UTAS Author:||Martin, A (Professor Angela Martin)|
|UTAS Author:||Scott, J (Professor Jenn Scott)|
|UTAS Author:||Venn, A (Professor Alison Venn)|
|UTAS Author:||Sanderson, K (Associate Professor Kristy Sanderson)|
|Web of Science® Times Cited:||12|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||397 View Download Statistics|
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