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Unlocking Hidden Costs: Measuring, Analyzing and Communicating Work Productivity Loss for Patients and Caregivers

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Work productivity is a vital aspect of our lives, impacting individuals, organizations, and society. But when someone is facing a health issue, their work productivity, and that of their caregivers, can often be affected. That’s why when evaluating the burden of illness or assessing health care interventions, it is crucial to measure work productivity loss resulting from health problems or caregiving. This measurement provides valuable insights into the impact on people’s ability to work, informs economic evaluations, aids in decision-making for patients, caregivers, and policy makers, and promotes workplace interventions that support employee well-being and productivity.

Jacynthe L’Heureux, Advancing Health Trainee

Patients and caregivers place high value on work productivity, as it directly affects their quality of life and economic welfare. Jacynthe L’Heureux, a PhD student at Advancing Health, emphasizes the significance of work productivity loss in patients’ minds. “One of the first things you think about when something happens to you is what’s going to happen with my work: What do I need to delegate? How much time am I going to miss? How is this going to affect my performance?” she said. “We know that work is an important facet of our lives. When a patient receives a diagnosis or is given details of an intervention or treatment plan, they need to know what that will mean for them from a practical standpoint.” 

Supported by BC SUPPORT Unit, a team including L’Heureux and Advancing Health Program Head of Health Economics Dr. Wei Zhang have been studying approaches that consider the perspectives of patients and caregivers to better understand, measure, analyze and communicate work productivity. 

How is work productivity loss measured and analyzed? 

The team first investigated the existing literature on work productivity loss and found a lack of consensus. They concluded that there was a need for standardized guidelines in measuring work productivity loss comprehensively, including all relevant outcomes and using appropriate analysis methods. Providing a comprehensive tool for researchers to capture all aspects of work productivity loss, such as absenteeism, presenteeism, and employment status changes, is a key recommendation from their research.  

Developed by a team including Advancing Health’s Drs. Wei Zhang, Nick Bansback, and Aslam Anis, the Valuation of Lost Productivity Questionnaire 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. 

Advancing Health Scientist Dr. Wei Zhang

“Work productivity loss is a patient-reported outcome. Now, we have even more evidence to say work productivity loss matters to patients and caregivers and, not only that, but they find all aspects of work productivity important,” L’Heureux explained. “It’s not only absence from work. It’s not just performance at work. It’s everything together. From the point of view of patients and caregivers, everything should be measured.”  

Drs. Wei Zhang and Huiying Sun, former Senior Statistician at Advancing Health, provide practical recommendations to help researchers when selecting the right model for analyzing work productivity loss. Dr. Zhang advises, “There are multiple questionnaires out there. Some are more specific to a certain population or are disease-specific. Selecting the right one is important. Make sure you have a way to capture all the outcomes: absenteeism, presenteeism and employment status changes and analyze these outcomes appropriately.”

How should we communicate about work productivity loss and health care? 

Communication of work productivity loss findings is essential for effective implementation. However, as L’Heureux explains, “If doctors or medical staff don’t know the language they should use when communicating the results, then they’re a step behind in helping their patients and their caregivers understand.” 

As the focus of their most recent publication, the team hopes to bridge that gap and have asked patients and caregivers how this information should be presented. Participants expressed the need for information that is easy to understand, presented in lay terms with visual aids, and includes details about the impact in terms of days and cost.  

“It’s exciting because we’re not telling researchers and care providers what to do. We’re saying we asked patients and caregivers, and they told us it should be done like that,” L’Heureux added.  

Providing pamphlets or online resources allows patients to compare options and understand the implications on work and life, helping them and their families make informed decisions in terms they find easy to understand.  

“A patient can go home and think, for example, ‘If I have surgery, I’ll be out of work for five days, but I’ll be fully functioning at work when I’m back. If I don’t have surgery, then I won’t miss work, but I might lose the equivalent of eight days because I won’t be able to fully perform my duties due to my condition.’ Patients can compare those options and make decisions based on what makes the most sense to them and their family, their caregivers,” she said.  

This information can also be shared with employers to plan ahead and provide necessary support for employees returning to work or managing caregiving commitments. 

When asked what she had gained from working on this project, L’Heureux talked about her experience collaborating with patients and caregivers on this project.  

“Patients and caregivers eagerly provided input, even on technical or abstract questions,” she shared, “They advocated for easily digestible and accessible information that respects their limited time.”  

Katrina Prescott, VOLP Caregiver Partner

For our recent Patient Partners article, caregiver Katrina Prescott shared, “Participating in research made a difference because my experience contributed to the body of knowledge that can influence change in long-term.” She added, “My involvement was when I could be involved and how I could be involved — it was entirely up to me.”  

L’Heureux observed that patients and caregivers were assertive when expressing their preferences, even apologizing for it, but it was precisely what the research team sought and valued.  

“In contrast to the research world’s tendency to emphasize asterisks and technical details, everyday life calls for straightforward and easily understandable information,” she said. 

By prioritizing clear and accessible communication, health care professionals can ensure that patients and caregivers have the necessary information to make informed choices and plan for the future. 

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