Workforce depression and job performance: Making maximum use of health and productivity information

This study examines how comorbid depression affects job performance among individuals who are being treated for a variety of chronic conditions and also analyzes the effects of health risk status on job performance for a subsample of employees with depression. The study used retrospective observational data over a 29-month period, including medical and pharmacy administrative claims and self-reported health risk appraisal (HRA) survey data. The medical and pharmacy claims-based identification criteria required an employee to have at least one physician visit, emergency department visit or inpatient stay with a condition-related ICD-9-CM diagnosis and at least one condition-related pharmacy prescription fill within a maximum of 18 months preceding the HPA completion date. The HRA survey used in this study contains a standard set of medical, lifestyle, and health risk indicators, along with items that capture self-reported data on chronic health conditions, absence, and job performance. About 8% to 9% of employees in the condition-medication subgroups had depression comorbidity. The study found that depression co-morbidity was significantly associated with a decline in job performance after controlling for age, gender, race/ethnicity, marital status, occupational class, number of chronic comorbidities, average paid medical and pharmacy claims per month, and health risk status. Among those with depression, high and medium health risk exhibited a significant influence on job performance compared to the low risk group. Functional outcomes including job performance measures can be used in concert with information on co-morbidities and health risks to develop holistic health management approaches for individuals with depression.