Health-related work productivity loss is low for patients in a methadone maintenance program in Vietnam

Abstract

Background: Data on work productivity lost are an essential component of economic evaluation regarding social issues. However, there has been limited information about the loss of work productivity due to health among patients receiving methadone maintenance treatment (MMT) in Vietnam. The objectives of this study were to explore health-related work productivity loss between urban and rural MMT patients and to identify associated factors.

Methods: A cross-sectional study was conducted in five MMT clinics in Hanoi and Nam Dinh provinces. Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH) was used to measure health-related work productivity loss. In addition, data on socio-demographic, health status (measured by EuroQol-5 dimensions-5 levels - EQ-5D-5L, and EQ-Visual analogue scale - EQ-VAS) and substance use were collected. Multivariate Tobit regression was used to identify the potential factors associated with health-related work productivity loss.

Results: Of 1016 patients who participated in the study, 755 (74.6%) were employed. Of those, only 40/755 patients reported missing work due to health problems (5.3%), with the average absenteeism score of 30.6% (SD = 18.5%). Meanwhile, 164/755 respondents (21.7%) reported their impairment during work hours due to health problems. The mean weekly cost of absenteeism was at US$ 19.6 (SD = 11.8), and the mean weekly presenteeism cost was at US$ 8.7 (SD = 7.3). After adjusting for socio-economic status, having problems with mobility, usual activities, pain/discomfort, and anxiety/depression; as well as EQ-5D index and EQ-VAS score, were factors associated with work productivity loss due to health.

Conclusion: The current study emphasizes the low degree of health-related work productivity loss, as well as the low rate of work impairment among MMT patients in Vietnamese urban and rural settings. Our study also highlights the necessity of appropriate pain and mental health management as well as vocational training, and the provision of job opportunities to promote the employability of patients taking MMT.

Keywords: Economic evaluation; Methadone; Vietnam; Work productivity.