Leigh J P, Seavey W, Leistikow B
Department of Epidemiology and Preventive Medicine, School of Medicine, University of California at Davis, 95616-8638, USA.
J Rheumatol. 2001 Jul;28(7):1647-54.
To present the first estimate of the costs of job related osteoarthritis (OA) in the USA.
Data were drawn from national data sets collected by the US Bureau of Labor Statistics, the US National Center for Health Statistics, and existing cost estimates for arthritis in the literature. We used proportional attributable risk (PAR) models to estimate the percentage of acute and repetitive injuries resulting in OA. These PAR vary between men and women. We used the human capital method that decomposes costs into direct categories such as medical expense and indirect categories such as lost earnings.
We estimate job related OA costs US$3.41 to 13.23 billion per year (1994 dollars). Our point estimate is that job related OA contributes about 9% ($8.3 billion) to the total costs for all OA. About 51% of job related costs result from medical costs and 49% from lost productivity at work and at home. These costs are likely to underestimate the true burden since costs of pain and suffering as well as costs to family members and others who provide home care are ignored.
The cost of job related arthritis is significant and has implications for both clinical and public policy. Depending on the PAR selected, job related arthritis is at least as costly as job related renal and neurological disease combined, and is on a par with the costs of job related chronic obstructive pulmonary disease and all asthma, whether job related or not.
首次估算美国与工作相关的骨关节炎(OA)的成本。
数据来自美国劳工统计局、美国国家卫生统计中心收集的全国数据集以及文献中现有的关节炎成本估算。我们使用比例归因风险(PAR)模型来估算导致OA的急性和重复性损伤的百分比。这些PAR在男性和女性之间有所不同。我们使用人力资本法将成本分解为直接类别,如医疗费用,以及间接类别,如收入损失。
我们估计与工作相关的OA每年成本为34.1亿至132.3亿美元(1994年美元)。我们的点估计是,与工作相关的OA占所有OA总成本的约9%(83亿美元)。约51%的与工作相关的成本来自医疗费用,49%来自工作和家庭中的生产力损失。这些成本可能低估了真实负担,因为疼痛和痛苦的成本以及家庭成员和提供家庭护理的其他人的成本被忽略了。
与工作相关的关节炎成本巨大,对临床和公共政策都有影响。根据所选的PAR,与工作相关的关节炎成本至少与与工作相关的肾脏和神经疾病的总成本相当,并且与与工作相关的慢性阻塞性肺疾病和所有哮喘(无论是否与工作相关)的成本相当。