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Measuring and valuing productivity loss due to poor health: A critical review


  • Zhang, Wei
  • Bansback, Nick
  • Anis, Aslam H.


The objective of this study is to review current measurement issues and valuation methods such as "human capital" and "friction cost" for estimating productivity loss due to illness. Since observed wages diverge from marginal productivity when allowances are made for sick days and workers are risk averse, or when a job type involves team production, unavailability of perfect substitutes, and/or time-sensitivity of output, productivity loss is likely to be underestimated. A multiplier adjusting wage to marginal productivity needs to be developed for practical use. We further consider the ramifications of measuring labour input loss due to illness in both paid and unpaid work as well as the inclusion of presenteeism to the more traditional approach of measuring only absenteeism. Although a number of instruments have been developed to measure presenteeism, they generate widely varying estimates of productivity loss. Further investigation is required to identify which instrument provides a better estimate. Finally, we provide recommendations on measurement methods such as using subjective measures due to the unavailability of objective measures and the appropriate recall periods. We conclude by proposing a generic measure instead of a disease-specific measure and discuss important perspective related issues.

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  • Zhang, Wei & Bansback, Nick & Anis, Aslam H., 2011. "Measuring and valuing productivity loss due to poor health: A critical review," Social Science & Medicine, Elsevier, vol. 72(2), pages 185-192, January.
  • Handle: RePEc:eee:socmed:v:72:y:2011:i:2:p:185-192

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    References listed on IDEAS

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    3. Marieke Krol & Jocé Papenburg & Siok Swan Tan & Werner Brouwer & Leona Hakkaart, 2016. "A noticeable difference? Productivity costs related to paid and unpaid work in economic evaluations on expensive drugs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(4), pages 391-402, May.
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    8. Mathieu-Bolh, Nathalie & Pautrel, Xavier, 2016. "Reassessing the effects of environmental taxation when pollution affects health over the life-cycle," Economic Modelling, Elsevier, vol. 52(PB), pages 310-321.
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    11. Part Sungkaew, 2020. "Labor Productivity Loss in Case of Death in Thailand," International Journal of Economics & Business Administration (IJEBA), International Journal of Economics & Business Administration (IJEBA), vol. 0(2), pages 488-500.
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    13. Krol, Marieke & Brouwer, Werner, 2015. "Unpaid work in health economic evaluations," Social Science & Medicine, Elsevier, vol. 144(C), pages 127-137.
    14. Hanna Waart & Johanna M. Dongen & Wim H. Harten & Martijn M. Stuiver & Rosalie Huijsmans & Jeannette A. J. H. Hellendoorn-van Vreeswijk & Gabe S. Sonke & Neil K. Aaronson, 2018. "Cost–utility and cost-effectiveness of physical exercise during adjuvant chemotherapy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 893-904, July.
    15. Nora Ruth Libertun de Duren, 2017. "La carga de la vivienda de interés social: Comparación entre hogares de la periferia y del centro en ciudades de Brasil, Colombia y México," IDB Publications (Working Papers) 8417, Inter-American Development Bank.
    16. Andronis, Lazaros & Maredza, Mandy & Petrou, Stavros, 2019. "Measuring, valuing and including forgone childhood education and leisure time costs in economic evaluation: Methods, challenges and the way forward," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    17. Jamison Pike & Scott D. Grosse, 2018. "Friction Cost Estimates of Productivity Costs in Cost-of-Illness Studies in Comparison with Human Capital Estimates: A Review," Applied Health Economics and Health Policy, Springer, vol. 16(6), pages 765-778, December.
    18. Manuel Flores & Melchor Fernández & Yolanda Pena-Boquete, 2020. "The impact of health on wages: evidence from Europe before and during the Great Recession," Oxford Economic Papers, Oxford University Press, vol. 72(2), pages 319-346.
    19. Przemysław Holko & Paweł Kawalec & Małgorzata Mossakowska & Andrzej Pilc, 2016. "Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-21, December.
    20. Kenneth Tang, 2015. "Estimating Productivity Costs in Health Economic Evaluations: A Review of Instruments and Psychometric Evidence," PharmacoEconomics, Springer, vol. 33(1), pages 31-48, January.
    21. Zhang, Wei & Sun, Huiying & Woodcock, Simon & Anis, Aslam, 2015. "Illness related wage and productivity losses: Valuing ‘presenteeism’," Social Science & Medicine, Elsevier, vol. 147(C), pages 62-71.
    22. Angelis, Aris & Kanavos, Panos, 2017. "Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework," Social Science & Medicine, Elsevier, vol. 188(C), pages 137-156.
    23. Tóthová Dominika, 2020. "Respiratory Diseases in Children and Air Pollution – The Cost of – Illness Assessment in Ostrava City," Central European Journal of Public Policy, Sciendo, vol. 14(1), pages 43-56, June.


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