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

Author(s):  
François Mach ◽  
Philippe Lyrer ◽  
Roger Hullin ◽  
Bernadetted Dwan ◽  
Cindy Wanger ◽  
...  

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.

2006 ◽  
Vol 33 (3) ◽  
pp. 219-226 ◽  
Author(s):  
Sangyoub Lee ◽  
Daniel W Halpin ◽  
Hoon Chang

This study quantifies the effects of accidents by defining one of the indirect costs, the productive time lost owing to accidents in utility trenching operations. The probability of accidents, estimated by fuzzy-logic-based analysis of the performance of the factors (training, supervision, and preplanning) affecting safety in utility trenching operations, was used to quantify, based on simulation analysis, the productivity loss due to process delays resulting from accidents during excavation and pipe installation. It was determined that the productivity loss resulting from accidents during excavation is greater than that resulting from accidents during pipe installation. During excavation, the "very poor" condition of preplanning is most critical to productivity loss due to accidents, whereas during pipe installation, the condition of training and supervision affects the productivity loss more than that of preplanning. This paper provides insights into the relationship between the condition of the safety factors and the possible productivity loss by concomitant probability of accidents to quantify the effects of the accidents.Key words: effect of accidents, probability of accidents, productivity, fuzzy logic, simulation.


2018 ◽  
Vol 21 ◽  
pp. S102
Author(s):  
C. Escobar Cervantes ◽  
D. Gomez-Ulloa ◽  
A. Elorriaga ◽  
J.M. García ◽  
Freijo Md ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043826
Author(s):  
Carl Willers ◽  
Emma Westerlind ◽  
Fredrik Borgström ◽  
Mia von Euler ◽  
Katharina S Sunnerhagen

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.


2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 74-74
Author(s):  
Yin Wan ◽  
Xin Gao ◽  
Sonam Mehta ◽  
Zhixiao Wang ◽  
Claudio Faria ◽  
...  

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]


2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Kari Haikonen ◽  
Pirjo M. Lillsunde

<em>Background</em>: The aim of this study was to assess the economic burden of fire-related injury from two perspectives: post-injury social security compensations and also productivity losses due to the lost productive time from a societal perspective induced by the injury. <br /><em>Design and methods</em>: A cohort of 1503 inpatients who sustained firerelated injury during the period 2001–2005 was retrospectively followed up for 5-10 years until the end of 2010, using linkages between several administrative registers. The study process was started in 2015 and finalized on March 2016. <br /><em>Results</em>: Annual productivity loss was on average EUR 5.72 million, giving a total for the five-year study period of EUR 28.6 million, with a mean value of EUR 19,070 per person. Mean/median disability time for those who received benefits was 572/63 days, ranging from 3 days to 36.5 years. Total average cost of benefits to the injured annually during the study period was EUR 1.03 million. This equates to EUR 3430 per patient for the whole cohort or EUR 14,860 for those who received benefits. <br /><em>Conclusions</em>: The burden of fire-related injuries in terms of payment transfers and lost productivity due to periods of disability as indirect costs is high; in a population of 5.4 million, the annual loss exceeded EUR 5.7 million. The results could be used in planning preventive measures and therefore yield savings


2021 ◽  
Vol 331 ◽  
pp. e157
Author(s):  
P. Valdivielso Felices ◽  
M.-A. Sanchez-Chaparro ◽  
L. Quevedo-Aguado ◽  
A. Sánchez Ramos ◽  
A.J. Vallejo-Vaz ◽  
...  

2021 ◽  
Vol 11 (6) ◽  
pp. 689
Author(s):  
Stefan Strilciuc ◽  
Diana Alecsandra Grad ◽  
Vlad Mixich ◽  
Adina Stan ◽  
Anca Dana Buzoianu ◽  
...  

Background: Health policies in transitioning health systems are rarely informed by the economic burden of disease due to scanty access to data. This study aimed to estimate direct and indirect costs for first-ever acute ischemic stroke (AIS) during the first year for patients residing in Cluj, Romania, and hospitalized in 2019 at the County Emergency Hospital (CEH). Methods: The study was conducted using a mixed, retrospective costing methodology from a societal perspective to measure the cost of first-ever AIS in the first year after onset. Patient pathways for AIS were reconstructed to aid in mapping inpatient and outpatient cost items. We used anonymized administrative and clinical data at the hospital level and publicly available databases. Results: The average cost per patient in the first year after stroke onset was RON 25,297.83 (EUR 5226.82), out of which 80.87% were direct costs. The total cost in Cluj, Romania in 2019 was RON 17,455,502.7 (EUR 3,606,505.8). Conclusions: Our costing exercise uncovered shortcomings of stroke management in Romania, particularly related to acute care and neurorehabilitation service provision. Romania spends significantly less on healthcare than other countries (5.5% of GDP vs. 9.8% European Union average), exposing stroke survivors to a disproportionately high risk for preventable and treatable post-stroke disability.


2021 ◽  
Author(s):  
Veronique Lambert-Obry ◽  
Jean-Philippe Lafrance ◽  
Michelle Savoie ◽  
Jean Lachaine

BACKGROUND Type 2 diabetes mellitus (T2DM) imposes a significant burden, with its increasing prevalence and life-threatening complications. In patients not achieving glycemic targets on oral antidiabetic drugs, initiation of insulin is recommended. However, a serious concern about insulin is drug-induced hypoglycemia. Hypoglycemia is known to affect quality of life and healthcare resource utilization. However, health economics and outcomes research (HEOR) data for economic modeling are limited, particularly in terms of utility values and productivity losses. OBJECTIVE The aim of this real-world prospective study is to assess the impact of hypoglycemia on productivity and utility in insulin-treated T2DM adults from Ontario and Quebec (Canada). METHODS This noninterventional, multicenter, 3-month prospective study will recruit patients from four medical clinics and two endocrinology/diabetes clinics. Patients will be identified using appointment lists, and enrolled through consecutive sampling during routinely scheduled consultations. To be eligible, patients must be ≥18 years of age, diagnosed with T2DM, and treated with insulin. Utility and productivity will be collected using the EQ-5D-5L questionnaire and the iMTA Productivity Cost Questionnaire (iPCQ), respectively. Questionnaires will be completed at 4, 8 and 12 weeks after recruitment. Generalized estimating equations (GEE) models will be used to investigate productivity losses and utility decrements associated with incident hypoglycemic events while controlling for individual patient characteristics. A total of 500 patients will be enrolled to ensure precision of HEOR estimates. RESULTS This study is designed to fill a gap in the Canadian evidence on the impact of hypoglycemia on HEOR outcomes. More specifically, it will generate productivity and utility inputs for economic modeling in T2DM. CONCLUSIONS Insulin therapies are expensive, and hypoglycemia is a significant component of economic evaluations. Robust HEOR data may help health technology assessment (HTA) agencies in future reimbursement decision making.


Author(s):  
Caroline Korves ◽  
Adi Eldar-Lissai ◽  
Doug Rodermund ◽  
Elyse Swallow ◽  
Alice Kate Cummings ◽  
...  

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


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