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Med Decis Making. 2014 Jan;34(1):127-37. doi: 10.1177/0272989X13497996. Epub 2013 Aug 1.

Exploring the validity of HPQ-based presenteeism measures to estimate productivity losses in the health and education sectors.

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Griffith Health Institute, Centre for Applied Health Economics, School of Medicine, Griffith University Logan Campus, Meadowbrook, Queensland, Australia (PAS).
Griffith Business School, Griffith Health Institute, Griffith University Gold Coast Campus, Gold Coast Mail Centre, Queensland, Australia (NV)
School of Population Health, The University of Queensland, Queensland Centre for Mental Health Research, Wacol, Queensland, Australia (HAW)



Illness-related presenteeism (suboptimal work performance) may be a significant factor in worker productivity. Until now, there has been no generally accepted best method of measuring presenteeism across different industries and occupations. This study sought to validate the Health and Work Performance Questionnaire (HPQ)-based measure of presenteeism across occupations and industries and assess the most appropriate method for data analysis.


. Work performance was measured using the modified version of the HPQ conducted in workforce samples from the education and health workforce in Queensland, Australia (N = 30,870) during 2005 and 2006. Three approaches to data analysis of presenteeism measures were assessed using absolute performance, the ratio of own performance to others' performance, and the difference between others' and own performance. The best measure is judged by its sensitivity to changes in health indicators.


. The measure that best correlated to health indicators was absolute presenteeism. For example, in the health sector, correlations between physical health status and absolute presenteeism were 4 to 5 times greater than the ratio or difference approaches, and in the education sector, these correlations were twice as large. Using this approach, the estimated cost of presenteeism in 2006 was $Aus8338 and $Aus8092 per worker per annum for the health and education sectors, respectively.


. The HPQ is a valid measure of presenteeism. Transforming responses by perceived performance of peers is unnecessary as absolute presenteeism correlated best with health indicators. Absolute presenteeism was more insightful for ascertaining the cost of presenteeism.


efficiency; human capital approach; productivity loss

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