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The Effects of Rheumatoid Arthritis on Labor Force Participation, Work Performance, and Healthcare Costs in Two Workplace Samples

Kessler, Ronald C. PhD; Maclean, J Ross MD; Petukhova, Maria PhD; Sarawate, Chaitanya A. MS; Short, Louise MD; Li, Tracy T. PhD; Stang, Paul E. PhD

Journal of Occupational and Environmental Medicine: January 2008 - Volume 50 - Issue 1 - p 88-98
doi: 10.1097/JOM.0b013e31815bc1aa
Original Articles

Objective: To assess the workplace costs of rheumatoid arthritis (RA) from the employer perspective.

Method: Samples included 4485 manufacturing firm (MF) employees (109 with RA) and 915 commercially insured (CO) subscribers (333 with RA). Respondents completed the Health and Work Performance Questionnaire (HPQ) and the Health Assessment Questionnaire (HAQ). The effects of RA were estimated using regression analysis.

Results: RA was associated with increased probability of no longer working (CO), increased effort to maintain work performance (CO), increased sickness absence (MF), and increased non-RA pharmacy costs (CO). RA was not associated with hours worked or hourly wage. Indirect costs of RA did not exceed direct medical costs.

Conclusions: Indirect costs of RA to employers are significant and warrant further research to increase our understanding of the contribution of different RA treatment interventions to optimizing workforce productivity.

From the Department of Health Care Policy (Drs Kessler and Petukhova), Bristol-Myers Squibb Company (Drs Maclean and Li), HealthCore, Inc. (Mr Sarawate, Dr Short), and The Primary Care Network (Dr Stang), Harvard Medical School, Boston, Mass.

Address correspondence to: Ronald C. Kessler, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115; E-mail:

©2008The American College of Occupational and Environmental Medicine