Part One: Understanding Presenteeism

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Michael Klachefsky

After hearing the term “presenteeism” defined for the first time, people generally have one of three reactions:

  • “Wow, sounds like how I sometimes feel at work.”
  • “My co-worker must have this because he is not pulling his weight.”
  • “What are the implications of presenteeism, and what can employers do about it?”

Simply put, presenteeism is a loss of productivity while at work due to a medical or mental condition.

Today’s increased attention on employer-sponsored health plans, the effects of health care reform and escalating benefit and production costs have made presenteeism a topic of increasing interest to employers. As employers strive to improve employee health, research has demonstrated that improved health not only means lower health care costs, it means improved employee productivity.

In the context of absence and disability, productivity is something everybody talks about, but nobody does anything about it. Very few people have been able to quantify productivity, until now. Recent research on presenteeism has made great strides in quantifying the productivity loss it causes. In future posts on this blog we will delve into these numbers in more detail.

Background on Presenteeism Research

Professionals in the field of Absence and Disability Management always knew that work absences (most caused by medical or mental conditions) reduce an employee’s productivity because he or she is not at work. No brainer. But many of us began to notice these employees often experienced a period of increasing incapacity (especially in the case of mental conditions) prior to the actual absence. We knew this period rendered these employees less productive than they were before.

By the 1990s, there was already considerable research on work absence and health care causing employers to pay more attention to these topics. Research on presenteeism was in its infancy.

At first, researchers faced a daunting problem. Measuring the productivity of workers in non-manufacturing industries such as education, financial services, government, etc. required the use of self-reporting instruments instead of the cold arithmetic of production. It took some years before researchers proved the reliability of specially designed self-report tools. These tools have the surveyed employees rating their own productivity and any loss due to a medical or mental condition. Now there are several, such as the Work Limitations Questionnaire and the Health and Performance Questionnaire, that have been demonstrated to be accurate.1,2

In the coming months we will continue to explore components of this fascinating topic including the following areas:

  • How is presenteeism measured?
  • What is the actual cost of presenteeism to employers?
  • What can employers do about it?
  • What are the productivity costs and implications of specific medical and mental conditions?

This is the first post in a series of entries on presenteeism.


1 Abstract of The validity and accuracy of the Work Productivity and Activity Impairment questionnaire—irritable bowel syndrome version (WPAI:IBS). 2004. U.S. National Library of Medicine, National Institutes of Health. Available at: Accessed May 6, 2011.

2 Abstract of Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. 2004. U.S. National Library of Medicine, National Institutes of Health. Available at: Accessed May 6, 2011.