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Estimating the Impact of Diabetes Mellitus on Worker Productivity Using Self-Report, Electronic Health Record and Human Resource Data

Tabano, David C., MA; Anderson, Melissa L., MS; Ritzwoller, Debra P., PhD; Beck, Arne, PhD; Carroll, Nikki, MS; Fishman, Paul A., PhD; Grossman, David C., MD, MPH

Journal of Occupational and Environmental Medicine: November 2018 - Volume 60 - Issue 11 - p e569–e574
doi: 10.1097/JOM.0000000000001441

Objective: We assessed the relationship between diabetes mellitus (DM) and measures of worker productivity, direct health care costs, and costs associated with lost productivity (LP) among health care industry workers across two integrated health care systems.

Methods: We used data from the Value Based Benefit Design Health and Wellness Study Phase II (VBD), a prospective study of employees surveyed across health systems. Survey and health care utilization data were linked to estimate LP and health care utilization costs.

Results: Mean marginal lost productive time per week was 0.56 hours higher for respondents with DM. Mean adjusted monthly total health care utilization costs were $467 higher for respondents with DM.

Conclusion: The impact of DM is reflected in higher rates of LP and higher indirect costs for employers related to LP and higher health care resource use.

Kaiser Permanente Institute for Health Research, Denver, Colorado (Tabano, Drs Ritzwoller, Beck, Carroll); University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado (Tabano); Kaiser Permanente Washington Health Research Institute, Seattle, Washington (Drs Anderson, Fishman, Grossman); Department of Health Services University of Washington, Seattle, Washington (Drs Fishman, Grossman).

Address correspondence to: David C. Tabano, MA, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO 80045 (

This research was funded by the Agency for Healthcare Research and Quality (AHRQ R18HS018913).

The authors have no conflicts of interest.

Copyright © 2018 by the American College of Occupational and Environmental Medicine