Health Insurances and the Health-Related Work Capacity of Retirement-Aged Workers

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jiannan Li ◽  
Bocong Yuan
Keyword(s):  
Work Capacity ◽  
Health Related

scholarly journals Predictors of health-related quality of life in musculoskeletal disease patients: a longitudinal analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110340
Author(s):  
Alfredo Madrid-García ◽  
Leticia León-Mateos ◽  
Esperanza Pato ◽  
Juan A Jover ◽  
Benjamín Fernández-Gutiérrez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Musculoskeletal Diseases ◽  
Work Capacity ◽  
Health Related Quality ◽  
Clinical Predictors ◽  
Related Quality ◽  
Health Related ◽  
Classification Index ◽  
San Carlos

Introduction: Rheumatic and musculoskeletal diseases (RMDs) have a significant impact on patients’ health-related quality of life (HRQoL) exacerbating disability, reducing independence and work capacity, among others. Predictors’ identification affecting HRQoL could help to place efforts that minimize the deleterious impact of these conditions on patients’ wellbeing. This study evaluates the influence of demographic and clinical predictors on the HRQoL of a cohort of RMD patients, measured using the Rosser classification index (RCI). Methods: We included patients attending the Hospital Clínico San Carlos (HCSC) rheumatology outpatient clinic from 1 April 2007 to 30 November 2017. The primary outcome was the HRQoL assessed in each of the patient’s visits using the RCI. Demographic and clinical variables extracted from a departmental electronic health record (EHR) were used as predictors: RMD diagnoses, treatments, comorbidities, and averaged HRQoL values from previous periods (for this last variable, values were imputed if no information was available). Association between predictors and HRQoL was analyzed using penalized generalized estimating equations (PGEEs). To account for imputation bias, the PGEE model was repeated excluding averaged HRQoL predictors, and common predictors were considered. Discussion: A total of 18,187 outpatients with 95,960 visits were included. From 410 initial predictors, 19 were independently associated with patients’ HRQoL in both PGEE models. Chronic kidney disease (CKD), an episode of prescription of third level analgesics, monoarthritis, and fibromyalgia diagnoses were associated with worse HRQoL. Conversely, the prescription in the previous visit of acid-lowering medication, colchicine, and third level analgesics was associated with better HRQoL. Conclusion: We have identified several diagnoses, treatments, and comorbidities independently associated with HRQoL in a cohort of outpatients attending a rheumatology clinic.

Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial

2020 ◽  
pp. 1-14
Author(s):  
Harald Baumeister ◽  
Sarah Paganini ◽  
Lasse Bosse Sander ◽  
Jiaxi Lin ◽  
Sandra Schlicker ◽  
...  
Keyword(s):  
Care Setting ◽  
Chronic Back Pain ◽  
Controlled Trial ◽  
Work Capacity ◽  
Routine Care ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> There is neither strong evidence on effective treatments for patients with chronic back pain (CBP) and depressive disorder nor sufficiently available mental health care offers. <b><i>Objective:</i></b> The aim is to assess the effectiveness of internet- and mobile-based interventions (IMI) as a scalable approach for treating depression in a routine care setting. <b><i>Methods:</i></b> This is an observer-masked, multicenter, pragmatic randomized controlled trial with a randomization ratio of 1:1.<b><i></i></b>Patients with CBP and diagnosed depressive disorder (mild to moderate severity) were recruited from 82 orthopedic rehabilitation clinics across Germany. The intervention group (IG) received a guided depression IMI tailored to CBP next to treatment-as-usual (TAU; including medication), while the control group (CG) received TAU. The primary outcome was observer-masked clinician-rated Hamilton depression severity (9-week follow-up). The secondary outcomes were: further depression outcomes, pain-related outcomes, health-related quality of life, and work capacity. Biostatistician blinded analyses using regression models were conducted by intention-to-treat and per protocol analysis. <b><i>Results:</i></b> Between October 2015 and July 2017, we randomly assigned 210 participants (IG, <i>n</i> = 105; CG, <i>n</i> = 105), mostly with only a mild pain intensity but substantial pain disability. No statistically significant difference in depression severity between IG and CG was observed at the 9-week follow-up (β = –0.19, 95% CI –0.43 to 0.05). Explorative secondary depression (4/9) and pain-related (4/6) outcomes were in part significant (<i>p</i> &#x3c; 0.05). Health-related quality of life was significantly higher in the IG. No differences were found in work capacity. <b><i>Conclusion:</i></b> The results indicate that an IMI for patients with CBP and depression in a routine care setting has limited impact on depression. Benefits in pain and health-related outcomes suggest that an IMI might still be a useful measure to improve routine care.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for France

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 65-77 ◽  
Author(s):  
Christine Lebrun-Frenay ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Mia Gannedahl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
Disability Status ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related

Introduction: To estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated. Objectives and methods: This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption and work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, in the societal perspective, in EUR 2015. Results: A total of 491 patients (mean age 47 years) participated; 82% were below retirement age, and of these 56% were employed. Employment was related to disease severity, and MS affected productivity at work for 90% of patients. Overall, 95% and 67% of patients experienced fatigue and cognition as a problem, respectively. The mean utility and annual costs were 0.735 and €22,600 at Expanded Disability Status Scale (EDSS) 0–3, 0.500 and €38,100 at EDSS 4–6.5, and 0.337 and €48,100 at EDSS 7–9, respectively. The average cost of a relapse was estimated at €2300. Conclusion: This study provides current data on MS in France that are important for developments of health policies and to estimate the value of current and future treatments.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for Austria

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 17-28 ◽  
Author(s):  
Thomas Berger ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Mia Gannedahl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
Disability Status ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related ◽  
Mean Cost

Introduction: In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated. Objectives and Methods: This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption and work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015. Results: A total of 516 patients (mean age, 53 years) participated in Austria; 72% were below retirement age, and of these, 46% were employed. Employment was related to disability, and MS affected productivity at work for 77% of those working. Overall, 94% and 67% of patients experienced fatigue and cognition as a problem. Mean utility and total annual costs were 0.778 and 25,100€ at Expanded Disability Status Scale (EDSS) 0–3, 0.579 and 44,100€ at EDSS 4–6.5, and 0.244 and 73,800€ at EDSS 7–9. The mean cost of a relapse was estimated at 2563€. Conclusion: This study illustrates the burden of MS on Austrian patients and provides current data on MS that are important for development of health policies.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for Belgium

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 29-40 ◽  
Author(s):  
Benedicte Dubois ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Mia Gannedahl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
Cognitive Difficulties ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related ◽  
Mean Cost

Introduction: In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated. Objectives and methods: This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption and work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015. Results: A total of 1856 patients (mean age: 54 years) participated in Belgium; 66% were below retirement age, and of these, 44% were employed. Employment was related to disease severity, and MS affected productivity at work in 85% of the patients. Overall, 95% and 72% of the patients experienced fatigue and cognitive difficulties, respectively, as a problem. Mean utility and annual costs were 0.703 and €26,400 at Expanded Disability Status Scale (EDSS) 0–3, 0.478 and €45,300 at EDSS 4–6.5, and 0.193 and €62,000 at EDSS 7–9. The mean cost of a relapse was estimated to be €3000. Conclusion: This study provides current data on MS in Belgium that are important for development of health policies and for estimating the value of current and future treatments.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results of the Czech Republic

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 41-52 ◽  
Author(s):  
Eva Havrdova ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Mia Gannedahl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Czech Republic ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
The Czech Republic ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related

Introduction: In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated. Objectives and methods: This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption and work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, in the societal perspective, in CZK 2015. Results: A total of 747 patients (mean age 47 years) participated; 86% were below retirement age and of these, 49% were employed. Employment was related to disease severity, and MS affected productivity at work for 82% of those working. Overall, 92% and 66% of patients experienced fatigue and cognitive difficulties as a problem. Mean utility and annual costs were 0.832 and 257,000CZK at Expanded Disability Status Scale (EDSS) 0–3, 0.530 and 425,500CZK at EDSS 4–6.5 and 0.141 and 489,000CZK at EDSS 7–9. The average cost of a relapse was estimated at 12,600CZK. Conclusion: This study provides current data on MS in the Czech Republic that are important for the development of health policies.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for Denmark

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 53-64 ◽  
Author(s):  
Peter Vestergaard Rasmussen ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Mia Gannedahl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cost Data ◽  
Cross Sectional ◽  
Disability Status ◽  
Related Quality ◽  
Health Related

Background: To estimate the value of treatments in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with cost data. This, in turn, requires that cost data be regularly updated. Objectives and Methods: This study is part of a cross-sectional retrospective study in 16 countries collecting current data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in 2015 Danish Kronor (DKK). Results: A total of 830 patients (mean age of 54 years) participated; 78% were below retirement age and of these, 43% were employed. Employment was related to disease severity, and MS was felt to affect productivity at work by 73% of patients, most often through fatigue. Overall, 95% and 65% of patients felt that fatigue and cognition, respectively, were a problem. Mean utility and costs were 0.770 and 196,900DKK at Expanded Disability Status Scale (EDSS) 0–3, 0.619 and 287,300DKK at EDSS 4–6.5, and 0.302 and 533,250DKK at EDSS 7–9. The average cost of a relapse was estimated at 19,000DKK. Conclusion: This study illustrates the burden of MS on Danish patients and provides current data that are important for the development of health policies.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for Spain

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 166-178 ◽  
Author(s):  
Celia Oreja-Guevara ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Daniela Capsa ◽  
Jennifer Eriksson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
Cognitive Difficulties ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related ◽  
Mean Cost

Introduction: In order to estimate the value of interventions in multiple sclerosis (MS) where lifetime costs and outcomes cannot be observed, outcome data have to be combined with costs. This requires that cost data be regularly updated. Objectives and methods: This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015. Results: A total of 462 patients (mean age 43 years) participated in Spain; 96% were below retirement age and of these, 45% were employed. Employment was related to disability, and MS affected productivity at work for 72% of those working. Overall, 92% and 64% of patients experienced fatigue and cognitive difficulties as a problem, respectively. Mean utility and total annual costs were estimated at 0.772 and €20,600 at Expanded Disability Status Scale (EDSS) 0–3, 0.486 and €48,500 at EDSS 4–6.5 and 0.182 and €68,700 at EDSS 7–9, respectively. The mean cost of a relapse was €2050. Conclusion: This study illustrates the burden of MS on Spanish patients and provides current data that are important for development of health policies.

scholarly journals New insights into the burden and costs of multiple sclerosis in Europe: Results for Poland

2017 ◽  
Vol 23 (2_suppl) ◽  
pp. 130-142 ◽  
Author(s):  
Krzysztof Selmaj ◽  
Gisela Kobelt ◽  
Jenny Berg ◽  
Ewa Orlewska ◽  
Daniela Capsa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Capacity ◽  
Outcome Data ◽  
Current Data ◽  
Cross Sectional ◽  
Disability Status ◽  
Related Quality ◽  
Experienced Fatigue ◽  
Health Related

Background: In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated. Objective and methods: This study is part of a cross-sectional retrospective study in 16 European countries collecting current data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in 2015 Polish Zloty (PLN). Results: A total of 411 MS patients (mean age = 40 years) participated in Poland; 94% were below retirement age, and of these, 59% were employed. Employment was related to disability, and MS affected productivity for 85% of those working. Overall, 97% and 71% of patients experienced fatigue and cognition as important problems, respectively. Mean utility and total annual costs were 0.686 and 48,700 PLN at Expanded Disability Status Scale (EDSS) 0–3, 0.521 and 59,200 PLN at EDSS 4–6.5 and 0.208 and 81,600 PLN at EDSS 7–9, respectively. The average cost of a relapse was 3,900 PLN. Conclusion: This study illustrates the burden of MS on Polish patients and provides current data that are important for developing health policies.

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