Lost Productivity in Stroke Survivors: An Econometrics Analysis

2016 ◽  
Vol 47 (3-4) ◽  
pp. 164-170 ◽  
Author(s):  
Manav V. Vyas ◽  
Daniel G. Hackam ◽  
Frank L. Silver ◽  
Audrey Laporte ◽  
Moira K. Kapral
Keyword(s):  
General Population ◽  
Logistic Models ◽  
Indirect Costs ◽  
Stroke Survivor ◽  
Canadian Community Health Survey ◽  
Stroke Survivors ◽  
Hourly Wage ◽  
Factors Associated ◽  
Lost Productivity ◽  
The Impact

Background: Stroke leads to a substantial societal economic burden. Loss of productivity among stroke survivors is a significant contributor to the indirect costs associated with stroke. We aimed to characterize productivity and factors associated with employability in stroke survivors. Methods: We used the Canadian Community Health Survey 2011-2012 to identify stroke survivors and employment status. We used multivariable logistic models to determine the impact of stroke on employment and on factors associated with employability, and used Heckman models to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). Results: We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted OR 0.39, 95% CI 0.33-0.46) and had hourly wages 17.5% (95% CI 7.7-23.7) lower compared to the general population, although there was no association between work hours and being a stroke survivor. We found that factors like older age, not being married, and having medical comorbidities were associated with lower odds of employment in stroke survivors in our sample. Conclusions: Stroke survivors are less likely to be employed and they earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies targeting return to work could be considered to address this lost productivity among stroke survivors.

scholarly journals E.01 Lost productivity in stroke survivors: a new econometrics model

2016 ◽  
Vol 43 (S2) ◽  
pp. S16-S16
Author(s):  
MV Vyas ◽  
DG Hackam ◽  
FL Silver ◽  
A Laporte ◽  
MK Kapral
Keyword(s):  
General Population ◽  
Stroke Survivor ◽  
Canadian Community Health Survey ◽  
Stroke Survivors ◽  
Hourly Wage ◽  
Heckman Model ◽  
Factors Associated ◽  
Community Health Survey ◽  
Lost Productivity ◽  
The Impact

Background: Stroke leads to a substantial societal economic burden. We aimed to characterize productivity and factors associated with employability in Canadian stroke survivors. Methods: We used the Canadian Community Health Survey (CCHS) 2010-2011 to identify stroke survivors and employment status. We used multivariable models to determine the impact of stroke on employment and factors associated with employability. We used the Heckman model to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). Results: We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted Odds Ratio 0.39, 95% CI 0.33 to 0.46) and had hourly wages 17.7% (95% CI 8.3% to 27.1%) lower compared to the general population, although there was no association between work hours and being a stroke survivor. Older age, being single and having medical comorbidities were associated with lower odds of employment in stroke survivors. Conclusions: Stroke survivors are less likely to be employed and earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies around return to work could be considered to address this lost productivity among stroke survivors.

Abstract 28: Effects of Self-Esteem, Optimism, and Perceived Control on Depression: Testing Dyadic Dynamics in Stroke Survivor-Spouse Dyads

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Misook L Chung ◽  
Tamilyn Bakas ◽  
Laurie D Plue ◽  
Linda S Williams
Keyword(s):  
Perceived Control ◽  
Stroke Survivor ◽  
Self Esteem ◽  
Stroke Survivors ◽  
Control Scale ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Actor Partner Interdependence Model ◽  
Patient Health ◽  
The Impact

Background: Depression is common in stoke survivors and their caregivers. Given the interdependent relationship among the members of dyads in post-stroke management, improving depression in dyads may depend on their partner’s characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depression in an individual, may also contribute to their partner’s depression. The purpose of this study was to examine whether an individual’s self-esteem, optimism and perceived control predict their own, as well as their partner’s depression. Methods: A total of 112 ischemic stroke survivor-spouse dyads completed surveys in which depression, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model (APIM) regression with distinguishable dyad was used to determine influences on depression within the dyad. In APIM, actor effect is the impact of a person’s factors on their own depression and partner effect is the impact of a person’s factors on their partner’s depression. Results: As shown in Figure1, individuals with lower self-esteem, optimism, and perceived control had higher level of depression. Spouses who had stroke survivors with low self-esteem had higher levels of depression. Stroke survivors who had spouses with lower self-esteem and optimism had higher levels of depression. Conclusion: Stroke survivor self-esteem and spouse self-esteem and optimism influenced their partner’s depression. These findings suggest that dyadic intervention is needed to improve depression for the dyads and that depressed stroke survivors may benefit from interventions that improve spousal self-esteem and optimism.

Abstract P207: Association Between Rehabilitation and Functional Outcomes of Stroke Survivors: A Population-Based Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Zahra Azizi ◽  
Pouria Alipour ◽  
Michael Rotondi ◽  
Chris I Ardern
Keyword(s):  
Functional Outcomes ◽  
Survey Design ◽  
Healthcare Access ◽  
Stroke Care ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Stroke Survivors ◽  
Primary Endpoints ◽  
Community Health Survey ◽  
The Impact

Background: The increasing rate of stroke and its consequent disabilities has contributed to a growing proportion of stroke survivors requiring rehabilitation. Further research is needed to understand the provision of rehabilitation in the community settings and relationship between variance in stroke care and patient outcomes. Hypothesis: To investigate the association between rehabilitation and functional outcomes of stroke survivors. Method: Data for this analysis was derived from the Canadian Community Health Survey (CCHS) (merged cycles 2013-2016: 237,121 participants). Participants reporting complications from stroke were selected to assess the effect of physiotherapy (PT) and other allied health (AH) utilization. Primary endpoints included need for assistance in activity of daily living (ADL) and injury due to fall in the past 12 months (Inj-Fall). All statistical analyses were performed using R (V.4.0.2) and survey design. Results: Overall, 3,773 (1.1%) patients with stroke (47% females, 71.1% older than 60 years) were studied. Total of 0.2% and 1.6% of stroke survivors in 2013-14 had consulted PT and AH compared to 9.1% and 21% in 2015-16, respectively. Consequently, the rate of need for ADL and Inj-Fall were significantly greater in 2013-14. In general, age was a significant predictor of low accessibility to PT (OR=0.66(0.51-0.85)) or AH (OR=0.79(0.66-0.93)) whereas no significant association between sex and access to PT or AH (P=0.1). As expected, higher income was associated with greater PT utilization (OR=2.11(1.1-4.2)). Finally, PT or AH consultations were significantly associated with less need for assistance in ADL and lower Inj-Fall (Table1). Conclusion: Results of this study reinforce the beneficial effect of rehabilitation on ADL and injury in stroke survivors. Future longitudinal work is necessary to understand directionality of the relationship, and the impact of healthcare access, within varied healthcare systems and models of health .

scholarly journals Racial Disparities in Stroke Recovery Persistence in the Post-Acute Stroke Recovery Phase: Evidence from the Health and Retirement Study

2020 ◽  
Vol 30 (2) ◽  
pp. 339-348
Author(s):  
Joy N. J. Buie ◽  
Yujing Zhao ◽  
Suzanne Burns ◽  
Gayenell Magwood ◽  
Robert Adams ◽  
...  
Keyword(s):  
Racial Differences ◽  
Motor Skills ◽  
Stroke Recovery ◽  
Fine Motor ◽  
Stroke Survivors ◽  
Factors Associated ◽  
Post Stroke ◽  
Stroke Disability ◽  
The Impact

Background and Purpose: Blacks have a higher burden of post-stroke disability. Factors associated with racial differences in long-term post-stroke disability are not well-understood. Our aim was to assess the long-term racial differences in risk factors associated with stroke recovery.Methods: We examined Health and Retire­ment Study (HRS) longitudinal interview data collected from adults living with stroke who were aged >50 years during 2000- 2014. Analysis of 1,002 first-time, non- Hispanic, Black (210) or White (792) stroke survivors with data on activities of daily liv­ing (ADL), fine motor skills (FMS) and gross motor skills (GMS) was conducted. Ordinal regression analysis was used to assess the impact of sex, race, household residents, household income, comorbidities, and the time since having a stroke on functional outcomes.Results: Black stroke survivors were young­er compared with Whites (69 ± 10.4 vs 75 ± 11.9). The majority (~65%) of Black stroke survivors were female compared with about 54% White female stroke survivors (P=.007). Black stroke survivors had more household residents (P<.001) and comor­bidities (P<.001). Aging, being female, being Black and a longer time since stroke were associated with a higher odds of hav­ing increased difficulty in ADL, FMS and/or GMS. Comorbidities were associated with increased difficulty with GMS. Black race increased the impact of comorbidities on ADL and FMS in comparison with Whites.Conclusion: Our data suggest that the effects of aging, sex and unique factors associated with race should be taken into consideration for future studies of post-stroke recovery and therapy.Ethn Dis. 2020;30(2):339-348; doi:10.18865/ ed.30.2.339

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]

Marriage after the transition to stroke: a systematic review

2017 ◽  
Vol 38 (11) ◽  
pp. 2241-2279 ◽  
Author(s):  
SHARON ANDERSON ◽  
NORAH KEATING
Keyword(s):  
Systematic Review ◽  
Quantitative Methods ◽  
Satisfaction With Life ◽  
Stroke Survivor ◽  
Future Research ◽  
Stroke Survivors ◽  
Qualitative And Quantitative Methods ◽  
Relationship Closeness ◽  
The Impact ◽  
The Relationship

ABSTRACTIn health and chronic illness, satisfying marriages promote wellbeing and life satisfaction, yet stroke research has focused on either the stroke survivor as the patient or the spouse as a care-giver. Using Pope, Mays and Popay's framework for synthesising qualitative and quantitative methods, we conducted a systematic review and synthesis of 39 peer-reviewed studies to determine what happens to marital relationships after one partner has suffered a stroke. All the articles examined the impact of stroke. Three overarching themes characterise the evolution of marriage after stroke: chaos in the marriage, work to re-establish the marriage and evolution of the marriages. While both the stroke condition itself and the survivors’ need for care undermined the emotional qualities of the relationship for some couples, about two-thirds were able to retain or regain the relationship closeness. As in other chronic illnesses, the relationship closeness and a couple's ability to collaborate contributed to the survivor's recovery and to the satisfaction with life of the stroke survivor and the spouse. Our results underscore the need to consider the quality of, and the qualities of, the relationship between stroke survivors and their spouses. Future research could include a greater focus on qualitative or mixed-methods approaches to explore the interactions between stroke survivors and spouses that impact the wellbeing of both partners.

scholarly journals Multi-Level Factors Associated with Social Participation among Stroke Survivors: China’s Health and Retirement Longitudinal Study (2011–2015)

2019 ◽  
Vol 16 (24) ◽  
pp. 5121 ◽  
Author(s):  
Yi Cai ◽  
Samuel D. Towne ◽  
C. Scott Bickel
Keyword(s):  
Longitudinal Study ◽  
Social Participation ◽  
Functional Limitations ◽  
Stroke Survivors ◽  
Social Activities ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Factors Associated ◽  
Multi Level ◽  
The Impact

Background: This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Methods: Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. Results: More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with the participation of going to a community club to play table games. Conclusion: Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.

Factors associated with perceived participation three months after being discharged from a tertiary hospital

2016 ◽  
Vol 31 (9) ◽  
pp. 1257-1266 ◽  
Author(s):  
Xuemei Chen ◽  
Yanan He ◽  
Xianmei Meng ◽  
Lanshu Zhou
Keyword(s):  
Social Relations ◽  
Rating Scale ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Stroke Survivors ◽  
Family Role ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Impact

Objectives: To describe how first-stroke survivors perceive their participation and the problems with such participation in life and to determine the factors associated with perceived participation at three months after hospital discharge. Design: A cross-sectional study. Setting: Patients were recruited from a tertiary hospital in Shanghai, China and they were followed up in their homes. Subjects: Two hundred and fifty-seven first-stroke survivors discharged for three months participated in this study. Measures: The Chinese version of the Impact on Participation and Autonomy questionnaire, Barthel Index, Chinese Stroke Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale. Results: One hundred thirty-four (52.1%) and 147 (57.2%) participants perceived their participation as poor to very poor in the domains of family role and autonomy outdoors, respectively. Conversely, 208 (80.9%) and 228 (88.7%) participants perceived their participation to be fair to good in the domains of social relations and autonomy indoors, respectively. The ability to perform activities of daily life was the strongest correlate of participation in the domains of autonomy indoors, family role, and autonomy outdoors, whereas anxiety was the strongest correlate of participation in the domain of social relations. Conclusions: Activities of daily living were significantly associated with perceived participation in almost all domains. In contrast, anxiety was an important factor in predicting participation in the domain of social relations. These findings suggest the need to explore different strategies of promoting participation for each domain.

scholarly journals Clinical Outcomes of COVID-19 and Impact on Disease Course in Patients with Inflammatory Bowel Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Panu Wetwittayakhlang ◽  
Farah Albader ◽  
Petra A Golovics ◽  
Gustavo Drügg Hahn ◽  
Talat Bessissow ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Systemic Corticosteroid ◽  
Clinical Activity ◽  
Health Care Centre ◽  
Factors Associated ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
The Impact

Background and Aims. The impact of COVID-19 has been of great concern in patients with inflammatory bowel disease (IBD) worldwide, including an increased risk of severe outcomes and/or possible flare of IBD. This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare of IBD activity. Methods. A consecutive cohort of IBD patients who were diagnosed with COVID-19 infection and followed up at the McGill University Health Care Centre was obtained between March 1, 2020, and April 30, 2021. Demographics, comorbidities, IBD (type, treatments, pre- and post-COVID-19 clinical activity, biomarkers, and endoscopic activity), and COVID-19-related outcomes (pneumonia, hospitalization, death, and flare of IBD disease) were analyzed. Results. A cohort of 3,516 IBD patients was included. 82 patients (2.3%) were diagnosed with COVID-19 infection (median age: 39.0 (IQR 27.8–48.0), 77% with Crohn’s disease, 50% were female). The prevalence of COVID-19 infection in IBD patients was significantly lower compared to the general population in Canada and Quebec (3.5% versus 4.3%, p < 0.001 ). Severe COVID-19 occurred in 6 patients (7.3%); 2 patients (2.4%) died. A flare of IBD post-COVID-19 infection was reported in 8 patients (9.8%) within 3 months. Biologic therapy was held during active COVID-19 infection in 37% of patients. Age ≥55 years (odds ratio (OR): 11.1, 95% CI: 1.8–68.0), systemic corticosteroid use (OR: 4.6, 95% CI: 0.7–30.1), active IBD (OR: 3.8, 95% CI: 0.7–20.8), and comorbidity (OR: 4.9, 95% CI: 0.8–28.6) were factors associated with severe COVID-19. After initial infection, 61% of IBD patients received COVID-19 vaccinations. Conclusion. The prevalence of COVID-19 infection among patients with IBD was lower than that in the general population in Canada. Severe COVID-19, mortality, and flare of IBD were relatively rare, while a large proportion of patients received COVID-19 vaccination. Older age, comorbidities, active IBD disease, and systemic corticosteroid, but not immunosuppressive or biological therapy, were associated with severe COVID-19 infection.

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