Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation).
Johns Hopkins University, Baltimore, MD, USA
BACKGROUND. Work limitations are functional limitations within the work context resulting from chronic illness producing a restricted ability to perform in one’s work role and can result in a loss of work and its economic benefits; psychological deterioration; permanent disability; escalating healthcare costs; and lost productivity. Little is known about the prevalence of; effect of morbidity burden on; and interventions to alleviate work limitations in employed persons with diabetes.
PURPOSE. The purpose of this study is to explore work limitations and the extent to which they are related to morbidity burden.
METHODS. Health system employees enrolled in a self-funded health insurance plan with a diagnosis of diabetes in administrative claims data were surveyed via Internet and postal mail regarding their experience with work limitations using the Work Limitations Questionnaire. Morbidity burden was measured using the Adjusted Clinical Groups methodology.
RESULTS. This study achieved a 26% response rate. Of the 385 respondents who met strong criteria for diabetes diagnosis, the average age was 49.6 years; 83% were female; the average years in the health plan was 7.2; 77% worked in a hospital setting; and 81% responded online. 72% had a work limitation. Those with high morbidity were more likely to have an overall work limitation, OR=1.808 (95% CI: 1.112, 2.940); a physical limitation, OR=2.273 (95% CI: 1.468, 3.520); a time limitation, OR=2.130 (95% CI: 1.392, 3.259); and an output limitation, OR=2.142 (95% CI: 1.397, 3.284). Those with an ACG-PM score of >0.5 were more likely to have a physical limitation, OR=2.690 (1.198, 6.042); time limitation, OR=2.280 (1.051, 4.495); and an output limitation, OR=2.130 (1.024, 4.433).
CONCLUSIONS. This study showed that people with diabetes experience a high prevalence of work limitations and have a higher likelihood of work limitations when they are sicker. Preventing and reducing work limitations in people with chronic illness is an important step towards reducing the economic and personal effects of work loss and disability and can be accomplished through nursing practice; national, state and local health-related policies; clinical programs; healthcare service delivery; and employment policies, procedures and practices.
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