Depressive symptoms, satisfaction with health care, and 2-year work outcomes in an employed population

Objective: The relationship of depressive symptoms, satisfaction with healt h care. and 2-year work outcomes was examined in a national cohort of emplo yees. Method: A total of 6,239 employees of three corporations completed surveys on health and satisfaction with health care in 1993 and 1995. This study us ed bivariate and multivariate analyses to examine the relationships of depr essive symptoms (a score below 43 on the Medical Outcomes Study Short-Form Health Survey mental component summary), satisfaction with a variety of dim ensions of health care in 1993, and work outcomes (sick days and decreased effectiveness in the workplace) in 1995. Results: The odds of missed work due to health problems in 1995 were twice as high for employees with depressive symptoms in both 1993 and 1995 as for those without depressive symptoms in either year. The odds of decreased ef fectiveness at work in 1995 was seven times as high. Among individuals with depressive symptoms in 1993, a report of one or more problems with clinica l care in 1993 predicted a 34% increase in the odds of persistent depressiv e symptoms and a 66% increased odds of decreased effectiveness at work in 1 995. There was a weaker association between problems with plan administrati on and outcomes. Conclusions: Depressive disorders in the workplace persist over time and ha ve a major effect on work performance, most notably on "presenteeism," or r educed effectiveness in the workplace. The study's findings suggest a poten tially important link between consumers' perceptions of clinical care and w ork outcomes in this population.