Glycemic Control and Absenteeism Among Individuals With Diabetes
- Kaan Tunceli, PHD1,
- Cathy J. Bradley, PHD2,
- Jennifer E. Lafata, PHD1,
- Manel Pladevall, MD, MS1,
- George W. Divine, PHD3,
- Allen C. Goodman, PHD4 and
- Sandeep Vijan, MD5
- 1Center for Health Services Research, Henry Ford Health System, Detroit, Michigan
- 2Health Administration, Virginia Commonwealth University, Richmond, Virginia
- 3Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan
- 4Department of Economics, Wayne State University, Detroit, Michigan
- 5Ann Arbor Veterans Affairs Health Services Research and Development, and the Department of Internal Medicine and Michigan Diabetes Research and Training Center, University of Michigan School of Medicine, Ann Arbor, Michigan
- Address correspondence and reprint requests to Dr. Tunceli, 1 Ford Pl., Suite 3A, Detroit, MI 48202. E-mail: ktuncel1{at}hfhs.org
The associations between adverse labor market outcomes and diabetes/diabetes complications are well described (1–8). Clinical guidelines have recommended standards for glycemic, lipid, and blood pressure control (9) that have been shown to prevent or delay the onset and progression of diabetes complications (10–16). It is possible that control of these symptoms can reduce absenteeism in employed patients. Two studies have examined the relationship between glycemic control and labor market outcomes including absenteeism (17,18), and this study adds to that literature by examining the cross-sectional associations between absenteeism from work and glycemic, lipid, and blood pressure control among individuals with diabetes.
RESEARCH DESIGN AND METHODS—
Patients were identified as having diabetes (n = 27,407) from administrative data available within a medical group in southeast Michigan between 1 June 2003 and 31 May 2004. From these patients, we selected those who were tested for A1C during the prior 12 months and aged 30–64 years (n = 11,324). Next, we drew a random sample of 1,000 patients stratified by glycemic control level (A1C <7.0, 7.0–7.99, 8.0–8.99, 9.0–9.99, or ≥10.0%). Several exclusions were made, including subjects who had died (n = 5), absence of a physician from whom to obtain permission for patient contacts (n = 72), patients’ inclusion in other research studies (n = 132), physician refusal (n = 46), incorrect diagnosis (n = 5), and language barrier (n = 13). The final sample comprised 727 patients for a telephone survey and had an overall participation rate among eligible subjects of 59% (n = 427). The response rate for eligible subjects who were contacted was 81% (n = 525).
The primary outcome was hours absent from work for any reason during the 4 weeks …
