THE IMPACT OF DIABETES CONTROL ON EMPLOYMENT AND WORK PRODUCTIVITY

关于对疾病管理和其他类似项目的投资的决定通常 由于缺乏关于这种努力对政策相关成果的影响的证据，这一问题受到阻碍。一 这样的知识空白就是这样的项目对劳动力市场结果的影响。我们建议进行一项 糖尿病控制(血糖、血脂和血压控制)影响的纵向研究 劳动力市场的结果。劳动力市场的结果包括工作残障、劳动力参与和工作 生产力。 使用全面的自动化数据系统(医疗记录、管理、实验室和 药房数据)可在大型多专科非营利性综合医疗保健提供系统中获得 在密歇根州东南部，我们将确定一群患有糖尿病的受雇健康计划成员。这些 个人将在基线时接受面谈，此后三年每年接受面谈。通过使用3年期 前瞻性队列设计和将访谈数据与自动化实验室测试结果联系起来，我们将能够 探讨糖尿病控制的现成临床措施与劳动力市场的关系 结果。我们的研究目的是：1)评估风险因素之间的横截面关系(即， 血糖、血脂和血压)水平和工作效率(广义定义包括每周平均 工作时间、工作损失天数(缺勤)、与健康相关的工作限制以及工作时的生产率 (出席)基线；2)调查基线风险因素水平之间的纵向关联 和劳动力参与度的变化，以及工作生产率的变化；3)估计变化的影响 在风险因素水平上，劳动力参与度和工作生产率的变化。 通过量化血糖、胆固醇和血压的变化对 劳动力市场结果，这项研究将向患者、家属、雇主和决策者通报 成功的糖尿病管理对劳动经济的影响。这项研究的结果不仅将告诉我们 从社会角度评估糖尿病管理项目的成本效益，但也提供了信息 雇主从赞助此类项目中获得的潜在投资回报(ROI)。

Decisions regarding investments in disease management and other similar programs are often hindered by the lack of evidence surrounding the impact of such efforts on policy relevant outcomes. One such void in knowledge is the impact of such programs on labor market outcomes. We propose to conduct a longitudinal study to examine the impact of diabetes control (glycemic, lipid, and blood pressure control) on labor market outcomes. Labor market outcomes include work disability, workforce participation, and work productivity. Using comprehensive automated data systems (medical records, administrative, laboratory, and pharmacy data) available within a large multi-specialty nonprofit integrated health care delivery system in southeast Michigan, we will identify a cohort of employed health plan members with diabetes. These individuals will be interviewed at baseline and annually thereafter for three years. By using a 3-year prospective cohort design and linking interview data with automated laboratory test results, we will be able to explore the relationships between readily available clinical measures of diabetes control and labor market outcomes. Our research aims are: 1) Evaluate the cross-sectional relationship between risk factor (i.e., glycemic, lipid, and blood pressure) levels and work productivity (defined broadly to include average weekly hours worked, work-loss days (absenteeism), health-related work limitations, and productivity while at work (presenteeism) at baseline.; 2) Investigate the longitudinal association between baseline risk factor levels and changes in labor force participation, and changes in work productivity; 3) Estimate the effect of changes in risk factor levels on changes in labor force participation and changes in work productivity. By quantifying the effect of changes in blood glucose, cholesterol, and blood pressure on changes in labor market outcomes, this study will inform patients, families, employers, and decision makers about the labor economic impact of successful diabetes management. The results of this research will not only inform societal perspective evaluations of the cost-effectiveness of diabetes management programs, but also inform employers of the potential return on investment (ROI) from sponsoring such programs.