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Worker Productivity | Alcohol & Substance Misuse Evaluation Measures

Healthier employees are less likely to call in sick. Companies can sometimes assess sick day use as the most direct measure to determine whether health programs are increasing worker productivity.1-8

Baseline

  • Determine the average number of sick days per employee over the previous 12 months related to alcohol or substance misuse
    • It will be difficult to measure when employees take sick leave directly related to alcohol or substance misuse, since employees are unlikely to report the causes of such illness. It may be more useful to measure sick leave clearly related to formal rehabilitation services
    • Increased employee absences on Monday may be a sign of alcohol and/or substance misuse
    • This measure may be less useful if there has been a large increase or decrease in numbers of employees over the past 12 months
  • Determine costs for worker absenteeism related to the complications of alcohol and substance misuse such as high blood pressure, heart disease or liver disease, including costs of replacement workers, costs in training replacement workers, and lost and delay in productivity if possible
  • Determine time employees spend during working hours participating in worksite supported alcohol or substance misuse-related worksite programs. As noted above, identifying absenteeism related to the effects of alcohol and substance misuse is challenging. Each employer will need to consider whether there are effective measurement options in their employee population
  • Additional validated surveys have been developed to provide employers with information about the indirect costs of untreated or undertreated employee health issues such as alcohol and substance misuse. Employers who use these health and productivity surveys on an ongoing basis can begin to evaluate the return on investment (ROI) of offering alcohol and substance misuse programs on employee absence or productivity. These surveys may be proprietary and may require a modest fee to use. Two examples are provided below: 
    • Health and Work Performance Questionnaire (HPQ) is a short, easy to administer self-report survey designed to estimate workplace indirect costs (absenteeism, reduced productivity, and injury due to accidents) of employee health problems developed by the World Health Organization (WHO) and the Harvard Medical School
    • The Work Limitations Questionnaire (WLQ) developed by the Health Institute at Tufts Medical Center is an easy to use questionnaire that addresses general work limitations which can be built into other health assessment tools such as a health risk appraisal or employee health survey

Process

  • Re-assess the average number of sick days per employee at the first follow-up evaluation (see limitations on this measure described above)◦If employee education programs are successful, these measures may increase in the short term as screening and detection rates increase (This only applies to using leave to obtain clinical preventive and treatment services)
  • Periodic repeats of other baseline measures

Outcome

  • Assess changes in the average number of sick days per employee in repeated follow-up evaluations
  • Assess changes in time employees spend during working hours participating in worksite supported alcohol or substance misuse-related worksite programs
  • Assess changes in costs from baseline

References

1.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

2.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

3.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.

4.  Substance Abuse and Mental Health Services Administration [Internet]. Washington, DC: [cited 2009 Nov 19]. Drug-Free Workplace Kit: Evaluate the Program: [about 4 screens]. 

5.  Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, Pronk N, Simon G, Stang P, Ustun TB, Wang P. The World Health Organization Health and Work Performance Questionnaire (HPQ). J Occup Environ Med. 2003 Feb;45(2):156-174.

6.  Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, Stang PE, Ustun TB. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004 Jun;46(6 Suppl):S23-37.

7.  Wang PS, Beck A, Berglund P, Leutzinger JA, Pronk N, Richling D, Schenk TW, Simon G, Stang P, Ustun TB, Kessler RC. Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys. J Occup Environ Med. 2003 Dec;45(12):1303-1311.

8.  Lerner D, Amick BC 3rd, Rogers WH, Malspeis S, Bungay K, Cynn D. The Work Limitations Questionnaire. Med Care. 2001 Jan;39(1):72-85

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