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Human Capital Management

Using integrated analytics to measure productivity and absence costs for employees with back and joint disorders

Workpartners and Better Health Worldwide presented this study during the 2022 AMCP Conference

Presenteeism refers to the loss of productivity when employees aren’t fully functioning at work because of illness or another medical condition. Presenteeism is hard to measure—it’s difficult to accurately assess that amount of lost productivity. If someone is at work, the employer might not know the employee has an issue. The employee might want to hide the fact that they’re unwell. They also may not fully realize themselves how much their work is suffering because of their condition.

Employers have often used self-reporting surveys to determine their rates of presenteeism, but it’s unsure how well these surveys represent actual health costs and absences.

Learning objectives

Many self-assessed presenteeism (SAP) surveys have serious limitations. They often do not:

  • Provide sample sizes for the populations reporting work productivity issues.
  • Confirm self-reported productivity levels with the actual observed level.
  • Validate the existence of comorbid conditions within existing medical or prescription claims.

Drawing on our proprietary Research Reference Database (RRDb), which has the broadest repository of person-level human capital data, Workpartners® collaborated in a study with Better Health Worldwide. The study assessed if existing SAP surveys accurately matched measured absence and health care costs for workers with back and joint disorders. It also measured the relationship between SAP and comorbidity risks, using Charlson Comorbidity Index (CCI) scores as well as Workpartners’ proprietary Human Capital Risk Index (HUI).

Key findings/Study populations

The study conducted a retrospective analysis of U.S. employees who completed an SAP survey between 2012 and 2019. Workers were asked the question, “How would you rate your overall job performance on the days you worked over the last four weeks (28 days)?” They were asked to rate themselves on a scale from 0–10, with 0 the worst possible job performance and 10 the performance of a top worker.

Each year’s respondents were checked to see if they filed claims for the following medical conditions:

  • Osteoarthritis (OA)
  • Other connective tissue disease (OCTD)
  • Spondylosis; intervertebral disc disorders; other back problems
  • Other non-traumatic joint disorders; other bone disease and musculoskeletal deformities
  • Sprains and strains

The study’s analysis compared respondents with the conditions listed above against those employees who did not report having these issues. For both groups, the study examined:

  • Direct medical and prescription drug costs.
  • Lost days and costs due to:
  • Sick leave.
  • Short- and long-term disability.
  • Workers’ compensation.
  • Objectively calculated comorbidity measures:
  • Workpartners’ Human Capital Risk Index (HUI).
  • Charlson Comorbidity Index (CCI) Scores.


The objective data revealed a different utilization pattern than what was suggested by SAP scores. Sprains and strains, an acute condition rather than a chronic condition, had the highest SAP. Those with chronic osteoarthritis had the lowest SAP but the highest comorbidity scores, highest costs, and most lost time.

Our analysis revealed that companies may want to focus more attention on those with acute conditions that may incur lower benefit costs but have higher rates of presenteeism.

View the Full Study


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