Ling Xiang, Nicholas Graves, Andrea H. L. Low, Ying-Ying Leung, Warren Fong, Wee-Hoe Gan, Mihir Gandhi, Julian Thumboo
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引用次数: 0
Abstract
Aim
Existing studies on the cost of inflammatory arthritis (IA) and osteoarthritis (OA) are often cross-sectional and/or involve patients with various disease durations, thus not providing a comprehensive perspective on the cost of illness from the time of diagnosis. In this study, we therefore assessed the cost of lost productivity in an inception cohort of patients with IA and OA in the year before and after diagnosis.
Methods
Employment status, monthly income, days absent from work, and presenteeism were collected at diagnosis and 1 year later to estimate the annual costs of unemployment, absenteeism, and presenteeism using human capital approach. Non-parametric bootstrapping was performed to account for the uncertainty of the estimated costs.
Results
Compared to patients with OA (n = 64), patients with IA (n = 102, including 48 rheumatoid arthritis, 19 spondyloarthritis, 23 psoriatic arthritis, and 12 seronegative IA patients) were younger (mean age: 52.3 vs. 59.5 years) with a greater proportion receiving treatment (99.0% vs. 67.2%) and a greater decrease in presenteeism score (median: 15% vs 10%) 1 year after diagnosis. Annual costs of absenteeism and presenteeism were lower in patients with IA than those with OA both in the year before (USD566 vs. USD733 and USD8,472 vs. USD10,684, respectively) and after diagnosis (USD636 vs. USD1,035 and USD6,866 vs. USD9,362, respectively).
Conclusion
Both IA and OA impose substantial cost of lost productivity in the year before and after diagnosis. The greater improvement in productivity seen in patients with IA suggests that treatment for IA improves work productivity.
目的:现有关于炎症性关节炎(IA)和骨关节炎(OA)成本的研究通常为横断面研究,且/或涉及不同病程的患者,因此无法提供从诊断开始的疾病成本的全面视角。因此,在本研究中,我们评估了一组 IA 和 OA 患者在确诊前后一年的生产力损失成本:方法:在诊断时和一年后收集就业状况、月收入、缺勤天数和出勤率,采用人力资本法估算失业、缺勤和出勤的年度成本。为了考虑估算成本的不确定性,采用了非参数引导法:与 OA 患者(64 人)相比,IA 患者(102 人,包括 48 名类风湿性关节炎患者、19 名脊柱关节炎患者、23 名银屑病关节炎患者和 12 名血清反应阴性的 IA 患者)更年轻(平均年龄:52.3 岁 vs. 59.5 岁),接受治疗的比例更高(99.0% vs. 67.2%),确诊 1 年后旷工评分下降幅度更大(中位数:15% vs. 10%)。在确诊前一年(分别为566美元对733美元和8472美元对10684美元)和确诊后一年(分别为636美元对1035美元和6866美元对9362美元),IA患者的缺勤和缺勤年成本均低于OA患者:结论:IA和OA都会在确诊前后一年内造成巨大的生产力损失。IA患者的生产力提高幅度更大,这表明IA治疗可提高工作生产力。