OBJECTIVES : High direct costs of cardiovascular comorbidities among patients with diabetes has been established, but little is known about productivity loss associated with cardiovascular comorbidities. The objective of this study was to estimate workplace absenteeism associated with cardiovascular comorbidities among diabetes patients.

METHODS : An observational, retrospective cohort analysis was conducted using 2015 Medical Expenditure Panel Survey (MEPS) data. Individuals 18 years old or older, diagnosed with diabetes, and employed during 2015 were included in the study sample. Individuals were excluded if they had missing data on any of the study covariates. Cardiovascular comorbidity was identified if an individual reported having ever been diagnosed with: coronary heart disease, angina or angina pectoris, heart attack or myocardial infarction, stroke, or other kind of heart disease. Workplace absenteeism was measured as days missed at work annually due to illness or injury in the year of 2015. SAS 9.4 for Linux and an alpha of 0.05 was used for all analysis. A generalized linear model (GLM) with negative binomial distribution and log link was used to assess association between cardiovascular comorbidities and workplace absenteeism among patients with diabetes. The GLM model adjusted for age, gender, race, education, family income, insurance coverage, self-perceived health status and duration of diabetes.

RESULTS : Among 617 individuals who met study selection criteria, approximately 45 percent were female and 67 percent were white. The mean (±standard deviation) age was 52.2 (±11.1) years. The prevalence of having cardiovascular comorbidity was 21.6% (95% Confidence interval, 95 %C.I.=18.4 - 25.0). Mean annual unadjusted workplace absenteeism associated with cardiovascular comorbidities was 3.7 days (95% C.I.=2.6 - 4.9, p<0.001). After adjusting for study covariates, mean annual incremental workplace absenteeism associated with cardiovascular comorbidities was 2.5 days (95% C.I.=1.4 - 3.7, p<0.001).

CONCLUSIONS : Cardiovascular comorbidity was associated with significant workplace absenteeism among patients with diabetes.