scholarly journals Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043826
Author(s):  
Carl Willers ◽  
Emma Westerlind ◽  
Fredrik Borgström ◽  
Mia von Euler ◽  
Katharina S Sunnerhagen
Keyword(s):  
Sick Leave ◽  
Ischaemic Stroke ◽  
Disability Pension ◽  
Social Insurance ◽  
Productivity Loss ◽  
Indirect Costs ◽  
Universal Healthcare ◽  
Income Groups ◽  
Life Years ◽  
Absence From Work

BackgroundStroke is one of the largest single-condition sources of the global burden of non-communicable disease in terms of disability-adjusted life-years and monetary costs, directly as well as indirectly in terms of informal care and productivity loss. The objective was to assess the population afflicted with ischaemic stroke in working age in the context of universal healthcare and social insurance; to estimate the levels of absence from work, the indirect costs related to that and to assess the associated patient characteristics.MethodsThis was a retrospective register-based study; all individuals registered with an ischaemic stroke during 2008–2011 in seven Swedish regions, covering the largest cities as well as more rural areas, were included. Individual-level data were used to compute net days of sick leave and disability pension, indirect costs due to productivity loss and to perform regression analysis on net absence from work to assess the associated factors. Costs related to productivity loss were estimated using the human capital approach.ResultsWomen had significantly fewer net days of sick leave and disability pension than men after multivariable adjustment, and high-income groups had higher levels of sick leave than low-income groups. There were no significant differences for participants regarding educational level, region of birth or civil status. Indirect monetary costs amounted to €17 400 per stroke case during the first year, totalling approximately €169 million in Sweden.ConclusionThe individual’s burden of stroke is heavy in terms of morbidity, and the related productivity loss for society is immense. Income-group differences point to a socioeconomic gradient in the utilisation of the Swedish social insurance.

scholarly journals Productivity loss and indirect costs in the year following acute coronary events in Switzerland

2021 ◽  
Author(s):  
François Mach ◽  
Philippe Lyrer ◽  
Roger Hullin ◽  
Bernadetted Dwan ◽  
Cindy Wanger ◽  
...  
Keyword(s):  
Sick Leave ◽  
Productivity Loss ◽  
Indirect Costs ◽  
First Year ◽  
Productivity Cost ◽  
Initial Hospitalisation ◽  
Coronary Syndrome ◽  
Coronary Events ◽  
Lost Work Time ◽  
Productive Time

Acute coronary syndrome (ACS) is highly prevalent in Switzerland and a leading cause of death. Associated productivity loss and indirect costs have rarely been studied. We investigated these factors in the first year after ACS in 24 Swiss patients (mean (SD) age 56 (8) years, 79% male). Data on patient productivity loss, absenteeism, presenteeism and caregiver assistance, were collected with the Productivity Cost Questionnaire during a routine cardiologist visit 3 to 12 months after hospitalisation for ACS and at least 4 weeks after patients returned to work. To estimate costs, lost hours were converted into 8-hour workdays, pro-rated to 1 year, combined with time off work due to initial hospitalisation and sick leave, and valued at Swiss labour costs. Additional data came from medical records. ACS patients lost on average (SD, range) 79 (81, 0.3–294) workdays; 38 (36, 0.3–153) days due to the initial hospitalisation and sick leave, 37 (75, 0–243) due to absenteeism after patients returned to work, and 4 (11, 0–41) due to presenteeism. Caregivers lost 10 (23, 0–90) additional workdays. The total indirect costs amounted to CHF 43,205 (44,026, 122–148,648); including CHF 18,514 (17,507, 122-74,619) for initial hospitalisation and sick leave and CHF 17,988 (36,394, 122–143,277) and CHF 1,849 (5181, 0–20,158) for absenteeism and presenteeism after patients returned to work, respectively. Costs of caregiver assistance amounted to CHF 4,855 (11,015, 0–43,843). This study showed that ACS patients lost on average 36% of their annual productive time. Caregivers lost an additional 5%. Lost work time was associated with substantial indirect costs that exceeded estimates of direct costs for ACS during 1 year. This suggests that costs and burden could be reduced through better risk reduction management.

scholarly journals P04.01 Return to work i patients with low grade glioma

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii28-iii28
Author(s):  
I Rydén
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Social Insurance ◽  
Control Sample ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Apparent Difference ◽  
Full Time ◽  
One Year ◽  
Absence From Work

Abstract BACKGROUND We now treat patients with low-grade gliomas (LGG) more aggressively as this prolong survival. Patients are typically in working age, but their ability to return to work (RTW) following treatment has not been studied. We aimed to study patterns of sick leave and return to work among LGG patients in Sweden. In addition, we explored predictors for RTW following LGG diagnosis. MATERIAL AND METHODS We performed a nationwide register-based study of patients with grade II diffuse LGG. Data on adult patients aged 18–60 years with a histopathological diagnosis of LGG between 2005–2015 were obtained from the Swedish Brain Tumor Registry (n=381). A matched control sample (n=1900) was acquired from Statistics Sweden. Patients and controls were linked to the social insurance agency data for individual information on sick leave and disability compensation. Multivariable logistic regression was used in order to find predictors for RTW. RESULTS One year prior to surgery there was no apparent difference between cases and controls with 90 % working. Among LGG patients there was a rapid increase in sick leave starting approximately six months prior to surgery, while the proportion of controls on sick leave remained constant. One year after surgery, 53 % had returned to work with 29 % working full time. Independent predictors for patients working one year after surgery were higher age (OR 0.96, 95 % CI 0.93–0.99, p <0.01) and more days absent from work prior to procedure (OR 0.91, 95 % CI 0.97-0.95, p <0.001), both negatively associated with RTW. CONCLUSIONS In this cohort, more than half of the patients being diagnosed with LGG RTW within one year. Higher prior absence from work and higher age are risk factors for no-RTW. This study provides new information on rates of and factors influencing RTW in patients with LGG. FUNDING This project was funded by research grant from the Swedish Research Council (2017-00944).

Indirect costs associated with metastatic breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 74-74
Author(s):  
Yin Wan ◽  
Xin Gao ◽  
Sonam Mehta ◽  
Zhixiao Wang ◽  
Claudio Faria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
General Population ◽  
Sick Leave ◽  
Productivity Loss ◽  
Metastatic Breast ◽  
Indirect Costs ◽  
Potential Cost ◽  
The Impact

74 Background: To estimate indirect costs (sick leave [SL]/short-term disability [STDI]) associated with metastatic breast cancer (MBC) compared to early stage breast cancer (EBC)/a general population without cancer (controls). Methods: The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or STDI were identified. Difference in SL and STDI days was calculated between MBC patients and their propensity score matched EBC cohort or controls during a 12-month follow-up period. Indirect costs due to SL/ STDI were estimated by multiplying leave days with daily wages (2011 Bureau of Labor Statistics). Generalized linear model was used to examine the impact of MBC on indirect costs and potential cost drivers. Results: A total of 139 MBC/432 EBC/820 controls and 432 MBC/1,552 EBC/4,682 controls were eligible for SL and STDI respectively (not mutually exclusive), with a mean age of 49/51/50 years. After matching by age, payer type, region, index year and comorbidities, no difference was found in SL days between MBC and EBC cohorts. MBC patients had more STDI days and related cost than EBC patients and controls, with higher total indirect costs (SL + STDI). MBC patients also had more SL days/cost than controls (Table). Controlling for covariates, MBC patients incurred 47% more STDI cost vs. EBC patients (p=.009). Older patients (p=.002), non-HMO payers (p<.05), or patients not receiving chemotherapy during follow-up (p<.001) were associated with lower STDI cost. MBC patients also incurred 56% (p=.01) more SL cost and 11.6 times (p<.001) more STDI cost than controls. Conclusions: Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or general population. These findings underscore the economic burden of MBC from US societal perspective. [Table: see text]

scholarly journals Costs of illness progression for different multiple sclerosis phenotypes: a population-based study in Sweden

2019 ◽  
Vol 5 (2) ◽  
pp. 205521731985838 ◽  
Author(s):  
Hanna Gyllensten ◽  
Andrius Kavaliunas ◽  
Chantelle Murley ◽  
Kristina Alexanderson ◽  
Jan Hillert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Sick Leave ◽  
Disability Pension ◽  
Indirect Costs ◽  
Health Related Quality ◽  
Cost Drivers ◽  
Related Quality ◽  
Health Related

Background Little is known of how the cost of illness and health-related quality of life changes over time after a diagnosis of multiple sclerosis. Objectives The aim was thus to explore the progression of annual direct and indirect costs and health-related quality of life among people with multiple sclerosis of working ages, following diagnosis with relapsing–remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS) or conversion to secondary progressive multiple sclerosis (SPMS) after RRMS. Methods Swedish nationwide registers were linked to estimate the annual cost of illness in 2006–2013 among people with a registered new multiple sclerosis phenotype, including: direct costs, indirect costs, and health-related quality of life. Results Drugs and indirect costs for sick leave were the main cost drivers after diagnosis with RRMS. After conversion to SPMS, the RRMS cost drivers were replaced by indirect costs for disability pension. The main cost driver in newly diagnosed PPMS was indirect costs for sick leave, later replaced by disability pension. Health-related quality of life scores were similar after RRMS and SPMS. Conclusions After initial high indirect costs for sick leave, people with RRMS had higher drug costs compared to people with PPMS. Cost drivers during SPMS initially followed the pattern in the RRMS population, but were replaced by indirect costs for disability pension.

scholarly journals Towards a Functional Performance Validation Standard for Industrial Low-Back Exoskeletons: State of the Art Review

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 808
Author(s):  
Mattia Pesenti ◽  
Alberto Antonietti ◽  
Marta Gandolla ◽  
Alessandra Pedrocchi
Keyword(s):  
Functional Performance ◽  
State Of The Art ◽  
Productivity Loss ◽  
Evaluation Criteria ◽  
The State ◽  
Low Back ◽  
Industrial Workers ◽  
Rigorous Evaluation ◽  
Work Related ◽  
Absence From Work

While the research interest for exoskeletons has been rising in the last decades, missing standards for their rigorous evaluation are potentially limiting their adoption in the industrial field. In this context, exoskeletons for worker support have the aim to reduce the physical effort required by humans, with dramatic social and economic impact. Indeed, exoskeletons can reduce the occurrence and the entity of work-related musculoskeletal disorders that often cause absence from work, resulting in an eventual productivity loss. This very urgent and multifaceted issue is starting to be acknowledged by researchers. This article provides a systematic review of the state of the art for functional performance evaluation of low-back exoskeletons for industrial workers. We report the state-of-the-art evaluation criteria and metrics used for such a purpose, highlighting the lack of a standard for this practice. Very few studies carried out a rigorous evaluation of the assistance provided by the device. To address also this topic, the article ends with a proposed framework for the functional validation of low-back exoskeletons for the industry, with the aim to pave the way for the definition of rigorous industrial standards.

Abstract P2: Medical Resource Utilization and Costs Following Hospitalization of Patients with Chronic Heart Failure in the United States

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Caroline Korves ◽  
Adi Eldar-Lissai ◽  
Doug Rodermund ◽  
Elyse Swallow ◽  
Alice Kate Cummings ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Sick Leave ◽  
Resource Utilization ◽  
Indirect Costs ◽  
The United States ◽  
Data Availability ◽  
Index Hospitalization ◽  
Medical Resource ◽  
Medical Resource Utilization

Background: The study objective was to determine medical resource utilization and direct and indirect costs following hospitalization with chronic heart failure (HF). Methods: Patients (Pts) with ≥1 hospitalization with a chronic HF claim (ICD-9 428.22, 428.32 or 428.42) were identified in a US commercial insurance claims database from 2004-2008. Pts were observed from beginning of first hospitalization (index hospitalization) for chronic HF until disenrollment or end of data availability. Inpatient, outpatient, and prescription drug data were used to estimate per patient per month (PPPM) utilization rates. Costs (2009 USD) were calculated per hospitalization and PPPM for patients ≤65 years, and included insurers’ reimbursement, patient out-of-pocket (OOP) and sick leave. Results: There were 7,814 pts (mean age 73.2 years, 55.7% (4,355/7,814) male) meeting inclusion criteria. Mean HF hospitalization length of stay increased from 6.7 days at index hospitalization to 8.2 days at fourth re-hospitalization. Rate of HF-related re-hospitalization remained over 0.045 PPPM throughout 24 months of follow-up, accounting for the majority of all-cause hospitalizations. Rate of all-cause and HF-related outpatient visits peaked at 4.0 and 0.59 visits PPPM, respectively, within the three months after index hospitalization. Index hospitalization was most expensive (Table). Patient OOP costs accounted for less than 10% of direct costs (Table) and sick leave costs were less than $1,800 at any hospitalization. During the study period, outpatient cardiovascular drugs accounted for a small proportion of total pharmacy costs; average PPPM cost varied from $88 to $124, less than 1% of the average cost of a HF-related hospitalization. Conclusions: Treating chronic HF pts is resource intensive. The greatest burden occurs within the three months after index hospitalization and pts continue to be burdened after hospitalization by high inpatient and outpatient visit rates. Index hospitalization HF-related re-hospitalization 1st 2nd 3rd 4th Total direct medical costs $31,998 $22,047 $23,946 $24,839 $24,517 Reimbursement by insurers $31,023 $21,521 $23,103 $23,781 $23,971 Patient out-of-pocket $975 $526 $843 $1,058 $546 Indirect costs (sick leave) $1,194 $1,194 $1,281 $1,703 $1,764 Total $33,192 $23,241 $25,227 $26,542 $26,281

Employee Well-being and Sick Leave, Occupational Accident, and Disability Pension

2011 ◽  
Vol 53 (6) ◽  
pp. 633-640 ◽  
Author(s):  
Jaana Kuoppala ◽  
Anne Lamminpää ◽  
Irma Väänänen-Tomppo ◽  
Katariina Hinkka
Keyword(s):  
Sick Leave ◽  
Disability Pension ◽  
Well Being ◽  
Occupational Accident

Problems in Work Participation and Resource Use Should Not Be Underestimated in Patients with Early Spondyloarthritis

2014 ◽  
Vol 41 (12) ◽  
pp. 2413-2420 ◽  
Author(s):  
Maria A.C. van der Weijden ◽  
Annelies Boonen ◽  
Irene E. van der Horst-Bruinsma
Keyword(s):  
Ankylosing Spondylitis ◽  
Sick Leave ◽  
Resource Use ◽  
Employment Status ◽  
Clinical Characteristics ◽  
Disease Duration ◽  
Productivity Loss ◽  
Work Participation ◽  
Considerable Proportion ◽  
Regression Analyses

Objective.To explore the effect of early spondyloarthritis (SpA) on worker participation and to investigate variables associated with work outcomes as well as the effect on resource use.Methods.Patients included in an early SpA cohort completed a questionnaire comprising items on employment status, sick leave, presenteeism, and resource use. Logistic regressions were used to investigate the associations between work status and clinical characteristics, and linear regressions were used to investigate the association between at-work productivity loss and clinical characteristics. Resource use across patient groups with different employment status was investigated with linear regression analyses.Results.One hundred forty patients participated in our study. Of the patients, 69% were male, the mean age was 41 years, and the disease duration was 4.8 years. Twenty-six patients (19%) were not employed because of SpA. Among 114 employed patients, sick leave was reported in 28% in the previous year. Forty-one percent of the patients reported reduced productivity at work. Multivariable regression analyses showed that high Bath Ankylosing Spondylitis Metrology Index and Ankylosing Spondylitis Quality of Life score were associated with not being employed and with reduced productivity at work. Annual costs of productivity loss attributable to sick leave and presenteeism amounted to €2000 per patient. Patients who reported sick leave show a higher (health-related) resource use.Conclusion.After only 5 years of diagnosis, a considerable proportion of patients with SpA is not employed, and those working have substantial sick leave and productivity loss. Among patients reporting sick leave, resource use is higher. Alertness to work participation even in patients with a short disease duration is urgently needed.

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