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Informing Policy

Time is Money: The Valuation of Lost Productivity Questionnaire

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Hand depositing clock in piggy bank

It’s clear that productivity is affected by absenteeism and presenteeism, but what we didn’t know was the impact of health conditions on productivity. If you are ill or caring for someone who is ill, what is the value of that time? To find out, there’s now a tool called Valuation Of Lost Productivity (VOLP).

Advancing Health Scientist Dr. Wei Zhang

Developed by a team including Advancing Health’s Drs. Wei Zhang, Nick Bansback and Aslam Anis, the VOLP is a composite questionnaire that measures time loss from paid work and unpaid work due to health problems, plus job and workplace characteristics, to calculate the monetary value of productivity loss.

The VOLP was adapted in 2021 to measure productivity loss associated with caregiving responsibilities and paint a picture of what it means to have caregivers out of the workforce from an economic perspective.

Not just numbers

Advancing Health Scientist Dr. Nick Bansback

It’s important to recognize that there are people behind the numbers. People who put their lives on hold due to sickness or responsibilities like caregiving. So, to ensure the VOLP questionnaire was effective for caregivers, it was important for the VOLP team to include those with lived experiences in the adaptation process. Caregiver partners help the VOLP capture what specific caregiving responsibilities are provided, the time spent on each type of these responsibilities, and uncover the impact of these responsibilities on caregivers paid and volunteer work status, absenteeism, presenteeism, and lost job opportunities.

The VOLP provides an economic snapshot of a caregiver’s lost productivity, and for Katrina Prescott, a caregiver partner involved in the VOLP, this was an important step in recognizing some of the work that is shouldered by caregivers.

VOLP Caregiver Partner Katrina Prescott

Ms. Prescott was excited to be a part of the VOLP process and provide her unique perspective, comments, and suggestions throughout the duration of the study. She explained, “When I first heard about this application of the VOLP, I was grateful that somebody cared about bringing into focus the countless blurry hours I spent as a caregiver. No one really knows how overwhelming the situation is for people who are in that position. There is no designated leave for people who are pausing their 9–5 career to provide care. There is no maternity leave-type of arrangement for people who aren’t welcoming a child, but they are supporting the life of another human being, whether that’s a parent, sibling, or friend.”

As for the urgency of recognizing the responsibility placed on caregivers, and the effects on our economy and health care system, Ms. Prescott added “Everyone at some point will be cared for, or provide care for someone. Needing care is a stage of life and we can’t treat it like it doesn’t exist anymore.”

Shedding light on invisible work

For close to a decade, Ms. Prescott was a caregiver for her mother Kathryn Love, who lived with dementia until the spring of 2022. Due to the invisible work of caring for her mother, Ms. Prescott’s career was forced into the rear-view mirror, literally, as the two sometimes spent eight hours a day on the road together. Being a passenger in a car was a rare activity her mother still enjoyed. So, Ms. Prescott created an office-on-wheels, taking work calls, picking up clients, and conducting meetings in her car. However, due to the time constraints of caregiving, she only worked with people familiar with her situation during this time, and had to turn down more lucrative contracts and any role that required travel.

Because of her experience, Ms. Prescott is using her voice as a caregiver partner in research to call for more recognition and support for unpaid family caregivers. After all, according to the Canadian Care Giving report, “if all caregivers took a week off, every Canadian would experience the collapse of our care systems before noon on the first day.”

As a caregiver partner in the VOLP research, Ms. Prescott was excited to be a part of important work that recognized the value of her contribution as a caregiver in a tangible way.

“The hours in the day can blend together, and the work of the VOLP really helps to bring light to the monumental time commitment it is to be a caregiver,” she said. “The research team was very open to my feedback and involvement, and what I was able to share made a difference to the final product, which will be used by so many.”

As for what the future holds, Ms. Prescott is issuing a warning about ignoring the aging population.

“Adequate and proper support for caregivers is a 911 situation. We can’t continue to ignore this emergency. As a society with an aging boomer demographic, more people will need care. And what’s going to happen to the generation that cared for the boomers? My mom had me to step into that role, but we can’t assume everyone will have a person to support them. For example, I don’t have kids and I wonder what supports will be available for me. I was in my mid-30s and mid-career when my priorities shifted to accommodate being a caregiver. Stepping into the role meant changing what my career path looked like and I had to compromise. It doesn’t have to be that way. There can be a healthy balance if caregivers and those receiving care are supported in the right ways.”

The right tool for the job

Tools like the VOLP are an important part of measuring the economic repercussions of a caregiver’s lost time from their paid work or completely exiting from the paid workforce.

“We need these data to get the attention that leads to change,” said Ms. Prescott. “When I took the VOLP, it was validating to finally see a number. As for the number itself, I was both surprised and not surprised– I was working and caregiving for so many hours a day I was barely sleeping. Seeing the VOLP measurement made it real. I now wonder how I got through that period, but it was survival mode. And often, the people who need the most help tend to have the least. Knowing the true costs of filling this role as a caregiver helps us as a society.”

Advancing Health Director Dr. Aslam Anis

As for the future of this tool, Ms. Prescott and two other patient/caregiver partners are co-investigators on a study with the VOLP research team that has just received a one-year CIHR project grant. This project will apply the VOLP caregiver version in a relatively large population-based study, which is the next step in preparing the tool for use in a number of settings.

Interested in using the VOLP?

There are long and short versions of the VOLP. The long version is a comprehensive questionnaire that includes components of absenteeism, presenteeism, unpaid work, routine work hours, job and work characteristics. The baseline long version includes 26 questions and the follow-up questionnaire includes 13 questions. Depending on employment status, questions can be skipped and thus the actual number of questions a respondent needs to answer is typically much smaller. The VOLP is currently available in 12 languages.

If you are interested in measuring and valuing productivity loss among patients and/or caregivers, or measuring the impact of certain interventions on their productivity loss, please email the VOLP team.