Chronic Condition Combinations and Productivity Loss Among Employed Nonelderly Adults (18 to 64 Years)

Document Type


Publication Date



Objective—We examined the relationship between specific chronic condition combinations and productivity loss measured by missed work days among nonelderly employed adults with at least two physical chronic conditions of arthritis, diabetes mellitus, heart disease, and hypertension. Methods—We analyzed data from the Medical Expenditure Panel Survey for the years 2004 to 2012. Results—Adults with arthritis/diabetes/heart disease had the highest average missed work days (14.42). In the adjusted model, compared with adults with arthritis/hypertension, adults with diabetes/heart disease and arthritis/heart disease/hypertension had significantly higher missed work days, while adults with diabetes/hypertension had significantly lower missed work days. Conclusion—Specific chronic condition combinations have a high burden of disease in terms of productivity loss. Work-place health programs that address multiple health conditions at the same time should be implemented to reduce missed work days.