Comparing self-reported presenteeism with objectively measured direct and indirect costs, lost time and comorbidity assessments for employees with headaches and migraines

To assess whether self-assessed presenteeism (SAP) for employees with headaches and migraines matches objectively measured absence and health care costs and comorbidity as measured by the Charlson Comorbidity Index (CCI). Retrospective analysis of Workpartners RRDb (2012—2019). For each year, employees who completed the Health Productivity Questionnaire [HPQ] or WebMD's SAP survey were checked for claims with ICD-9/-10 codes within the US Agency for Healthcare Research and Quality’s (AHRQ) "Headache (including migraine)” category. Employees had continuous eligibility for the calendar year they completed a survey and were included each year eligible. Analysis focused on the # of employees completing the survey, with each condition, each cohorts’ medical and prescription costs, and lost days and costs due to leaves (for sick leave [SL], short- and long-term disability [STD, LTD] and workers’ compensation [WC]), and the CCI. Claims start the year initiated. Employees with Headaches completed >20,000 SAPs with an average SAP=14.4% (S.E.=0.1%) which was 101.9% of the SAP for all conditions and ranked 97/283 AHRQ categories’ RRDb SAP-scores. Employees with Headaches ranked 228, 207, 108 and 104 for SL, STD, LTD, and WC costs, respectively and 213, 203, 114, and 28, for SL, STD, LTD, and WC days, respectively. Employees with Headaches had a mean CCI score 0.43 (S.E.=0.01, ranked 215); annual mean medical [$8214 (S.E.=$136, ranked 228), 42.5% of average] and prescription [$2575 (S.E.=$78, ranked 173), 58.4% of average] costs; annual mean WC costs $172 (S.E.=22) and days 0.70 (S.E. 0.27). The CCI correlation with medical costs was 0.37 and 0.35 using the Pearson and Spearmen tests (both P<0.0001). Despite the high SAP ranking, compared to other conditions, employees with Headaches had lower direct (medical and prescription) costs, costs/days for SL and STD. The results suggest the high SAP scores for employees with Headaches are related to the high WC days.