• Promoting a Healthier Workforce

    Health and Productivity Management

  • Health and Productivity Management Center

    Health and Productivity Terms and Definitions

    Absenteeism: The number of days missed from the workplace1. It can be attributed to workers’ compensation, short term disability, long term disability, sick leave, Family Medical Leave Act (FMLA), paid time off (PTO), unpaid leave, and death (premature mortality costs).

    Direct Costs: In this case, the dollars that are paid to others for health services. It is associated with the provision of medical insurance benefits (medical, pharmacy, dental, mental health), disability payments, and workers' compensation losses. Direct costs represent only a fraction of what employers spend to keep workers healthy and on the job2.

    Employee Health Coalition (EHC) of Tampa Assessment Instrument: The first portion of this questionnaire captures general information on employee productivity as well as patient demographics, salary information, healthy behaviors, health status metrics, co-morbidities, household health information, health plan utilization, health plan satisfaction, provider satisfaction, and process-of-care metrics. The second portion consists of a disease-specific questionnaire inquiring about the impact of a specific disease on the individual’s productivity along with the outcomes of care and the utilization of medication and alternative therapies (Frank Brocato)3.

    Employee Turnover/Replacement Costs: Represents economic impact of turnover and includes the decreased productivity output associated with the cost of hiring and training new employees4.

    Health and Performance Questionnaire (HPQ): A brief self-reported instrument designed to assess the impact of health on four aspects of work functioning: time missed from work, performance while at work, injuries or illnesses at work, and job turnover (Ronald Kessler, PhD)3. For more information: http://www.hcp.med.harvard.edu/hpq.

    Health and Productivity Management (HPM): The joint management of the many types of programs and services designed to address all dimensions of employee health. This will include all prevention programs and services and those that employees may access when they are sick, injured, or balancing work/life issues. These include medical benefits, disability and workers' compensation programs, employee assistance programs (EAPs), paid sick leave, health promotion and occupational safety programs. HPM also refers to activities meant to enhance morale, reduce turnover, and increase on-the-job productivity5.

    Health-Related Productivity: The dimension of productivity impacted by health or “health-related productive capacity”.

    Health Risk Assessment (HRA): An epidemiologically based questionnaire that identifies which health conditions an individual is at risk for based on a combination of their lifestyle, health related habits, genetic factors (family history), medical history, and current health risks.

    Human Capital: The knowledge, skills, competencies, and attributes embodied in individuals that facilitate the creation of personal, social, and economic well-being6.

    Indirect Costs: The costs associated with replacement workers, overtime premiums, productivity losses related to unscheduled absences, and productivity losses of workers while on the job5.

    Migraine Work and Productivity Loss Questionnaire (MWPLQ): This tool was designed to measure the impact of migraine headache on a patient's work performance. The questionnaire measures difficulties performing on-the-job work demands due to migraine (Debra Lerner)3.

    Presenteeism: Describes the degree to which an employee who is present and fully functioning while they are at work. It addresses the situation where an employee is present at work but limited in some aspect of job performance by health problem(s). It includes (1) time not on task (e.g. in the workplace, but not working); (2) decreased quality of work (e.g. increased injury rates, product waste, product defects); (3) decreased quantity of work; (4) unsatisfactory employee interpersonal factors (e.g., personality disorders); and (5) unsatisfactory work culture3.

    Return on Investment: the savings in medical costs associated with an employer investing in health, wellness, and safety programs. It is important for employers to understand the entire impact of health on the organization in order to target the interventions where the opportunities are greatest.

    Stanford Presenteeism Scale (SPS-6): This instrument is designed to assess how an individual’s health condition affects his behavioral, emotional and cognitive functioning at work (Kenneth Pelletier, PhD)3.

    Work Limitations Questionnaire (WLQ): This tool measures the impact of chronic diseases and treatment for on-the-job work performance. The WLQ consists of four demand scales: time, physical, mental-interpersonal, and output (Debra Lerner, PhD)3.

    Work Productivity and Activity Impairment Questionnaire (WPAI): This instrument assesses productivity losses by measuring the effect of general health and symptom severity on work productivity (Margaret Reilly)3.


    1. Burton W, Conti D. The real measure of productivity. Business & Health. 1999; 34-36.

    2. Greenberg PE, Finkelstein SN, Berndt ER. Economic consequences of illness in the workplace. Sloan Manage Rev. 1995;36:4,26.

    3. Loeppke R, Hymel PA, Lofland JH, Pizzi LT, Konicki DL, Anstadt GW, Baase C, Fortuna J, Scharf T. Health-related workplace productivity measurement: General and migraine-specific recommendations from the ACOEM Expert Panel. J Occup Environ Med. 2003; 45: 349-359.

    4. Koopmanschap MA, Rutten FF, van Ineveld BM, van Roijen L. The friction cost method for measuring indirect costs of disease. J Health Econ. 1995; 14:171-89.

    5. Goetzel RZ, Guindon AM, Turshen IJ, Ozminkowski RJ. Health and productivity management: establishing key performance measures, benchmarks, and best practices. J Occup Environ Med. 2001; 43: 10-17.

    6. The Evidence on Human Capital. In The Well-being of Nations: The Role of Human and Social Capital (p. 18). Centre for Educational Research and Innovation, Organisation for Economic Co-operation and Development. 2001