Depression's surprising toll on worker productivity

Employers need to adopt a broad set of measures to combat depression, which has a serious impact on health care costs and productivity. They should start by conducting an assessment of the various ways depression surfaces and prepare carefully designed responses, involving HR, the EAP, line managers/supervisors, health plan vendors, managed behavioral firms, disability program managers and PBMs, among others. With such an approach, ultimately employers should realize improved medical plan costs, reduced disability expenditures, lower absence rates and enhanced productivity.     

健康管理与企业生产力提高

本文探讨了现代企业生产力管理中健康管理的作用,提出健康管理是2j世纪企业提升生产力的新战略,是提高健康资源效益的有效途径。企业对健康的投资是一种重要的人力资本投资,健康管理是现代企业全面提高竞争力的必要手段。     

Decomposition of total factor productivity in world health production: a stochastic frontier approach

While countries around the globe have increased spending on health care, economists and policy makers have raised concerns over the productivity and efficiency of health care. This article applies a stochastic frontier approach to address this issue using data from 141 countries for the period 1993 to 1997. From the perspective of productivity change, our results suggest that gains in population health will be greater provided that more resources are allocated to investment in human capital. We also show that the scale component accounts for 65–70% of the productivity change. That is, omitting the scale component in our case will result in a significant underestimation of the decline in the productivity of world health production. We do not find evidence supporting the hypothesis that production frontiers differ between Organization for Economic Cooperation and Development (OECD) and non-OECD countries. However, the change in productivity and scale elasticity do vary significantly between these countries.     

The impact of scientific research on health care: Evidence from the OECD countries

This paper investigates the impact of scientific research on health care productivity in a set of OECD countries, in the years from 1960 to 2008. To this end, we have matched information collected from the OECD Health Data 2010 with data gathered from the Scopus database on the papers published and their relative citations. Our empirical results suggest that medical research plays an important role in explaining health care productivity, although various countries are characterized by different velocities in assimilating scientific knowledge. Another important result that emerges from our work is that countries characterized by a faster absorption of academic science, such as the US, have on average a milder impact of scientific research on health productivity, compared with countries with slower absorption. As one would expect, we also find that countries absorbing more scientific research also bear higher health costs.Results from this study may support policy makers in designing incentive mechanisms to improve the impact of medical research on the health care system.     

Labour market discrimination on the basis of health: an application to UK data

An analysis of wage discrimination is carried out on the basis of health on UK data with a number of important modifications. First selection is controlled for into both health and labour market status. Second the direct effect of health upon productivity is accounted for and third, discrimination is examined with regard to participation as well as wages. The question of selection into health status is found to be of little empirical importance but taking account of selection into labour market status and the direct impact of health upon productivity leads to a fall in measured discrimination. The paper finds similar results with regard to participation. It is also examined whether these effects differ across age and gender.     

营养、健康与效率——来自中国贫困农村的证据

运用来自中国贫困农村的数据 ,本文系统地研究了营养、健康对劳动生产率或者说收入的影响。在控制着营养和健康变量“内生性”的前提下 ,本文估计了不同的营养和健康指标在中国贫困农村的回报和弹性。结果表明 ,几乎所有的营养和健康方面都影响到农村的劳动生产率 ,其中 ,营养摄入和疾病的影响最为显著。平均来看 ,卡路里拥有量每增加 1 % ,种植业收入会相应增加 0 57% ;而家庭劳动力因病无法工作时间每增加一个月 ,种植业收入将减少 2 3 0 0元。这些结果说明 ,要想使农民摆脱贫困的束缚 ,投资于营养和健康具有至关重要的作用。     

Health IT adoption,productivity and quality in primary care

Within the last decade, there has been a growing push towards the use of electronic medical records and health information technology (IT) within primary care physician practices. Despite financial subsidies, smaller practices remain reluctant to adopt these information systems. Using a nationally representative survey of physicians, this study explores the relationship between physician, practice and area attributes and the adoption of health IT systems. Controlling for these attributes, the analysis subsequently studies the relationship between health IT, physician productivity and perceived quality of care. It finds that smaller practices and physicians with lower incomes are less likely to adopt health IT systems and that adoption varies with the type of medical conditions the practice typically treats. With regards to productivity, health IT adopters are more likely to see fewer patients and spend a larger amount of time on each visit with marginal increases in time on administrative tasks and no differences in perceived ability to deliver quality health care.     

Health and schooling investments in Africa.

This paper first outlines an organizing framework for considering how health and schooling affect labor productivity and growth, and how household and community factors can in turn affect the demand for these human capital investments. Both cross-country growth models and various aspects of microeconomic studies of individual productivity as related to education and health are discussed. The conclusion offers some tentative leads for policy in this area based on existing research, and an agenda for future research.     

Defining quality of nursing work life

As the largest single employee component of hospitals, nurses are critical to the functioning of the organization, and improving employee productivity continues to be a common theme in the health care literature. However, any increased productivity will be transitory if achieved at the expense of the quality of nurses' work life (QNWL), since improvement in the QNWL is prerequisite to improved productivity. The conceptual components of the concept of QNWL that differentiate QNWL from the concept job satisfaction are explored.     

A nonparametric analysis of insufficient wage incentives in the Chinese health industry

ABSTRACT

This study provides empirical results on the insufficient wage incentives in the Chinese health industry, which may result in the poor productivity of high-ability medical personnel. We first propose a signaling game by capturing the progressive wage incentive in this industry. Then, we show that the model primitives are nonparametrically identified and estimable using recently developed methodologies related to measurement errors. Adopting a dataset from the China Household Income Project, we provide empirical evidence of the negative influence of insufficient wage incentives on the productivity of high-ability workers, especially those in higher job positions. As the number of high-ability workers in higher job positions is high, it is important to improve wage incentives in the Chinese health industry, especially for workers in higher job positions, to promote the productivity of high-ability medical workers.     

Mental Health and Wellbeing and Unemployment

This article examines the relationship between mental health and wellbeing and unemployment utilising the 1995 National Health Survey (1995 NHS) and the 1997 National Survey of Mental Health and Wellbeing of Adults (1997 SMHWB) data sets. Three indicators of mental health and wellbeing are adopted. The first is a psychological wellbeing measure derived from responses to questions included in the 1995 NHS on time felt down, happy, peaceful, and nervous (the SF-36 mental health scale). The second indicator relates to diagnoses of mental disorders including substance use disorders, affective disorders and anxiety disorders. Our final indicator relates to suicidal thoughts and plans and (unsuccessful) suicide attempts. On the basis of these measures, unemployed persons exhibit poorer mental health and wellbeing outcomes than the full-time employed.     

50 is the new 30—long-run trends of schooling and retirement explained by human aging

Workers in the US and other developed countries retire no later than a century ago and spend a significantly longer part of their life in school, implying that they stay less years in the work force. The facts of longer schooling and simultaneously shorter working life are seemingly hard to square with the rationality of the standard economic life cycle model. In this paper we propose a novel theory, based on health and aging, that explains these long-run trends. Workers optimally respond to a longer stay in a healthy state of high productivity by obtaining more education and supplying less labor. Better health increases productivity and amplifies the return on education. The health accelerator allows workers to finance educational efforts with less forgone labor supply than in the previous state of shorter healthy life expectancy. When both life-span and healthy life expectancy increase, the health effect is dominating and the working life gets shorter if the intertemporal elasticity of substitution for leisure is sufficiently small or the return on education is sufficiently large. We calibrate the model and show that it is able to predict the historical trends of schooling and retirement.     

Factors influencing work productivity and intent to stay in nursing

The researchers document the individual and workplace characteristics associated with decreased work productivity and intent to stay in nursing for nurses employed in direct patient care in the hospital setting. Factors associated with decreased work productivity were age, total years worked as a RN, quality of care provided, job stress score, having had a job injury, and having a health problem. Nurse leaders must place additional efforts on changes needed to improve the hospital workplace environment to decrease job stress, improve RNs' ability to provide quality care, and to assure the health and safety of nurses. Reducing job stress and providing adequate staffing so quality of care can be provided will enhance job satisfaction which will also encourage RNs to stay at the bedside. Improved work environments may delay older RNs' retirement from the workforce.     

Workplace problems,mental health and substance use

Little is known about how workplace problems may influence diagnosable mental health and substance use (MHSU) disorders. We examine the associations between three common workplace problems (experiencing problems with co-workers, job changes and perceived financial strain) and three MHSU disorders (mood, anxiety and substance abuse/dependence). The analysis utilizes longitudinal data on a sample of working-age adults from the National Epidemiological Survey on Alcohol and Related Conditions. These data are well suited for our research objective as the survey was specifically designed to study MHSU disorders. Results show that experiencing these workplace problems is associated with an increased risk for mental health disorders, but not substance use disorders. Importantly, various robustness checks and sensitivity analyses demonstrate that our findings cannot be not fully explained by omitted variables, reverse causality or sample attrition.     

The Productivity Commission Inquiry Report into Mental Health—A Commentary from a Health Economics Perspective

The Productivity Commission's Inquiry Report into Mental Health makes extensive recommendations to improve population mental health as a means of further enhancing productivity and economic growth. While providing an invaluable high‐level vision for reforming current mental health and social systems at a programmatic level, it lacks supporting evidence that would guide implementation of specific recommendations. We discuss important methodological considerations used to measure the output of the mental health sector and present clinical and cost‐effectiveness evidence, supporting selected recommendations. We suggest the development of a broad‐based health technology assessment process to facilitate consistent decision making across health and other government sectors.     

Income Variation and Health Expenditure: Evidence for OECD Countries

The purpose of this paper is to analyze the role health investment plays in human capital accumulation, and in so doing to demonstrate that education is not the only factor affecting the performance of the labor force and productivity. Estimates are made for the OECD countries for the period 1960–90. Investment in health contributes in a significant way to explaining variations in output through human capital, even in those countries which presumably have high levels of health.     

HEALTH CARE IN THE UNITED STATES: WHY IS SUPPLY SO PRICE INSENSITIVE?

Health spending as a percentage of gross domestic product in the U.S. economy is growing, from 5% in 1960 to about 16% in the current period, and it is predicted to grow to as much as 30% in 2050. Then why is the supply of health care in the United States so insensitive to steeply rising prices? This paper conducts an econometric study to show that high health‐care costs have an adverse impact on labor productivity, causing a negative production externality in all industries. So, can the rising cost of health‐care affect the U.S. comparative advantage? The paper seeks answers to these questions in a general equilibrium model and finds that the labor productivity shock is responsible for the sluggish or declining supply of health care. Consumers are able to afford less health care due to a possible decline in real wages. U.S. comparative advantage becomes a nonissue, provided that the equilibrium is stable in spite of a negatively sloped health‐care supply curve. Negative externality, leading to market failure, may be addressed in two alternative ways. (JEL F11, I11, I12, I18)     

影响卫生行业发展的因素分析与实证检验

在中国卫生行业快速发展的过程中,政府对卫生行业发展财政支出不足、医疗费用增长超过居民可支配收入增长等因素制约着卫生行业的发展。针对中国医疗卫生行业发展影响因素,通过对国民总收入、政府卫生预算支出和劳动生产率增长率三个主要因素进行理论分析与实证检验,应主要从制度的创新和管理水平的提高两方面来促进医疗卫生行业的发展。     

Does health insurance reduce illness-related worker absenteeism?

The objective of this article is to examine whether having health insurance reduces illness-related absenteeism among older workers. A nationally representative sample of 1780 workers in the United States, aged 52–64, are drawn from the 2004–2006 Health and Retirement Study (HRS). Binary logistic regressions and censored Tobit models are estimated for workers’ likelihood of missing work days due to illness and the number of illness-related work days missed, respectively, while explicitly addressing the possibility of insurance-selection effects. The findings suggest that over a 12-month period, older workers without health insurance are as likely as insured workers to miss work days due to illness and there are no differences in the number of days missed between insured and uninsured workers. However, there is strong evidence that poor baseline health, onset of new diseases and longer hospitalization significantly increase an older worker's absenteeism at work. These results suggest that having health insurance does not affect illness-related absenteeism among older workers in the US. Future research examining other aspects of worker productivity, such as ‘presenteeism’, and the longer term effects of insurance on productivity can extend our understanding of the role of health insurance in the workplace.     

生态系统健康与农业可持续发展

生态系统健康已成为生态学一个热点研究领域,目前关于生态系统健康的概念很多,许多学者分别从不同的角度对生态系统健康概念进行了阐述。农业可持续发展和农业生态系统健康是同一层面的意思,一个健康的农业生态系统或者说一个可持续发展的农业体系应具有良好的生态环境、健康的农业生物、合理的时空结构、清洁的生产方式,以及具有适度的生物多样性和持续的农业生产力。文章论述了生态系统健康和农业可持续发展的内涵,提出了相应的评价指标体系,并指出研究生态系统健康和农业可持续发展还应该重视农业生态学的研究和应用。