Presenteeism worse than Absenteeism -I didn't know

Woody Allen once said that 80% of success in life can be attributed to simply showing up. But growing research in recent past is showing it otherwise. I was reading one of the issues of HBR (while boarding yesterday) on “managing health care” and came across a very interesting term – PRESENTEEISM- the problem of workers being on the job but not fully functioning because of illness or other medical conditions and which can cut down the individual productivity by one third or more. In fact, presenteeism appears to be a more costlier problem that it counterpart – absenteeism. Worse still, unlike absenteeism, presenteeism is not always apparent. The hidden cost of Presenteeism is pyramidical source: page 35, "Presenteeism - at work- but out of it", Paul Hemp, HBR on Managing Health Care
Presenteeism, as defined by researchers, is not about malingering or goofing up at work but refers to productivity losses resulting from real health problems. Presenteeism is on the assumption that employees don’t take their jobs lightly (by choice or otherwise) and would work if they can. Many of the medical problems that result in presenteeism are relatively benign – seasonal allergies, asthma, migraines, back pain, arthritis, gastrointestinal disorders and depression. Most of these illnesses which we take with us to work, even though they incur far less direct costs usually account for a greater loss in productivity mainly because they are so prevalent, so often go untreated and typically occur during peak working years. It affects both quantity as well as quality of the work output. One study, quotes this article, concludes that in 2006, depression costed $35 billion in terms of reduced performance while pain conditions such as arthritis, headaches and back aches problems cost nearly $ 47 billion. Pain, no matter what the cause, will always translate into lost time at work. (dark shade bars represent the loss of productivity on account of presenteeism vis-a-vis light shaded bars which are on account of absebteeism)
Presenteeism also appears to cost companies more than they spend directly on medical treatment and drugs. Typically, studies have shown that presenteeism costs employers two to three times more than direct medical care ie insurance premiums or employee claims.
While these studies are based in US, the problem I guess is universal and has started manifesting itself equally in India too. Somewhere the traditional mindset that longer working hours are linked to better output also has been contributing to lesser productivity with inverse economies on time scale. No surprises that increasingly, corporate world is setting up ‘employee friendly’ workplaces – gyms, walking tracks, meditation rooms and play areas in office space and during office hours.

The term Presenteeism, as I understand, is now widely used to convey any activity during working hours which brings down the productivity.