THE IMPACT OF DIABETES CONTROL ON EMPLOYMENT AND WORK PRODUCTIVITY

关于疾病管理和其他类似项目投资的决定往往是 由于缺乏有关这些努力对政策相关成果的影响的证据，这方面的工作受到阻碍。一 这种知识的空白是这种方案对劳动力市场结果的影响。我们建议进行一项 一项纵向研究，旨在检查糖尿病控制（血糖、血脂和血压控制）对 劳动力市场的结果。劳动力市场结果包括工作残疾，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、行政、实验室和 药房数据）在一个大型的多专业非营利综合医疗保健提供系统中可用， 在密歇根州东南部，我们将确定一组患有糖尿病的就业健康计划成员。这些 将在基线时对个人进行访谈，此后每年进行一次访谈，为期三年。通过使用3年 前瞻性队列设计，并将访谈数据与自动化实验室检测结果联系起来，我们将能够 探索糖尿病控制的现成临床措施与劳动力市场之间的关系 结果。我们的研究目的是：1）评估危险因素（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）、与健康有关的工作限制和工作时的生产率 （出勤率）在基线。2)调查基线风险因素水平之间的纵向关联 劳动力参与率的变化，以及工作生产率的变化; 3）估计变化的影响 风险因素水平对劳动力参与率和工作生产率变化的影响。 通过量化血糖、胆固醇和血压的变化对血糖、胆固醇和血压变化的影响， 劳动力市场的结果，这项研究将告知患者，家庭，雇主和决策者关于 成功管理糖尿病对劳动力经济的影响。这项研究的结果不仅将告知 糖尿病管理计划的成本效益的社会角度评价，但也告知 雇主的潜在投资回报（ROI）从赞助这些计划。

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.