Department of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
Soc Sci Med. 2012 Dec;75(11):1981-8. doi: 10.1016/j.socscimed.2012.07.012. Epub 2012 Jul 27.
Productivity costs related to paid work are commonly calculated in economic evaluations of health technologies by multiplying the relevant number of work days lost with a wage rate estimate. It has been argued that actual productivity costs may either be lower or higher than current estimates due to compensation mechanisms and/or multiplier effects (related to team dependency and problems with finding good substitutes in cases of absenteeism). Empirical evidence on such mechanisms and their impact on productivity costs is scarce, however. This study aims to increase knowledge on how diminished productivity is compensated within firms. Moreover, it aims to explore how compensation and multiplier effects potentially affect productivity cost estimates. Absenteeism and compensation mechanisms were measured in a randomized trial among Dutch citizens examining the cost-effectiveness of reimbursement for smoking cessation treatment. Multiplier effects were extracted from published literature. Productivity costs were calculated applying the Friction Cost Approach. Regular estimates were subsequently adjusted for (i) compensation during regular working hours, (ii) job dependent multipliers and (iii) both compensation and multiplier effects. A total of 187 respondents included in the trial were useful for inclusion in this study, based on being in paid employment, having experienced absenteeism in the preceding six months and completing the questionnaire on absenteeism and compensation mechanisms. Over half of these respondents stated that their absenteeism was compensated during normal working hours by themselves or colleagues. Only counting productivity costs not compensated in regular working hours reduced the traditional estimate by 57%. Correcting for multiplier effects increased regular estimates by a quarter. Combining both impacts decreased traditional estimates by 29%. To conclude, large amounts of lost production are compensated in normal hours. Productivity costs estimates are strongly influenced by adjustment for compensation mechanisms and multiplier effects. The validity of such adjustments needs further examination, however.
与有偿工作相关的生产力成本通常通过将相关的工作天数乘以工资率估算值来计算，这在健康技术的经济评估中很常见。有人认为，由于补偿机制和（或）乘数效应（与团队依赖性以及缺勤情况下找到合适替代者的问题有关），实际的生产力成本可能低于或高于当前的估算值。然而，关于这些机制及其对生产力成本的影响的实证证据很少。本研究旨在增加对公司内部如何补偿生产力下降的了解。此外，它旨在探讨补偿和乘数效应如何潜在地影响生产力成本估算。旷工和补偿机制是在一项针对荷兰公民的随机试验中测量的，该试验研究了戒烟治疗报销的成本效益。乘数效应从已发表的文献中提取。应用摩擦成本法计算生产力成本。随后，根据（i）正常工作时间的补偿，（ii）与工作相关的乘数，以及（iii）补偿和乘数效应，对常规估算进行了调整。根据参与带薪工作、在过去六个月中有旷工经历以及完成旷工和补偿机制问卷，共有 187 名参与试验的受访者被纳入本研究。其中超过一半的受访者表示，他们的旷工在正常工作时间内由自己或同事得到了补偿。仅计算正常工作时间未得到补偿的生产力成本就使传统估算值减少了 57%。校正乘数效应使常规估算值增加了四分之一。同时考虑这两个影响，使传统估算值减少了 29%。总之，大量的生产损失得到了正常时间的补偿。生产力成本估算受补偿机制和乘数效应调整的强烈影响。然而，需要进一步检查这些调整的有效性。
