Work productivity, associated risk factors and costs on presenteeism and absenteeism in Chinese patients with young-onset type-2 diabetes in Hong Kong

Abstract

Aims: Those with young-onset type-2 diabetes (YOD), diagnosed before age of 40 years, experience heightened risk of complications. The economic burden extends beyond medical costs, impacting work productivity. Materials and Methods: Chinese patients with YOD were recruited between June 2023 and April 2024 in the Precision Medicine to redefine Insulin Secretion and Monogenic diabetes Trial in Hong Kong (NCT04049149). Presenteeism and absenteeism were measured using the World Health Organization Health and Performance Questionnaire. Results: Of the 639 invited participants, 603 (94%) completed the questionnaire, with 444 employed participants with type-2 diabetes (40.1% female, 80.4% 40–50 years, 32.9% 5–10 years with diabetes, 53.3% hemoglobin A1c (HbA1c) <7.0%, 75.2% low-density lipoprotein cholesterol <2.6 mmol/L, 42.3% body mass index ≥25 < 30 kg/m2). Participants reported mean presenteeism score of 7.34/10, 93.9% experiencing productivity loss with 0.48 mean sick days. Increased productivity was associated with females, child care, flexible work schedules and higher salary. Reduced productivity was related to, albuminuria, use of lipid-lowering medications and more sick leaves. With approximately 38 700 patients with YOD in Hong Kong, territory-wide productivity losses are projected to reach US$444 million annually (presenteeism: US$419 million, absenteeism: US$25 million). Conclusions: This study is the first to quantify productivity costs in Chinese patients with YOD, highlighting the need for work place policies, intensive treatment and management strategies to enhance support for individuals with YOD.