Vijan Sandeep, Hayward Rodney A, Langa Kenneth M
Vetterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, MI, USA.
Health Serv Res. 2004 Dec;39(6 Pt 1):1653-69. doi: 10.1111/j.1475-6773.2004.00311.x.
Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation.
We used the Health and Retirement Study (HRS), a national household sample of adults aged 51-61 in 1992, as a data source.
We conducted cross-sectional analyses on the baseline HRS data, and longitudinal analyses using data from eight years of follow-up. We used two-part regression models to estimate the adjusted impact of diabetes on workforce participation, and then estimated the economic impact of diabetes-related losses in productivity.
Diabetes is a significant predictor of lost productivity. The incremental lost income due to diabetes by 1992 was 60.0 billion US dollars over an average diabetes duration of 9.7 years. From 1992 to 2000, diabetes was responsible for 4.4 billion US dollars in lost income due to early retirement, 0.5 billion US dollars due to increased sick days, 31.7 billion US dollars due to disability, and 22.0 US dollars billion in lost income due to premature mortality, for a total of 58.6 billion dollars in lost productivity, or 7.3 billion US dollars per year.
In the U.S. population of adults born between 1931 and 1941, diabetes is associated with a profound negative impact on economic productivity. By 1992, an estimated 60 billion US dollars in lost productivity was associated with diabetes; additional annual losses averaged 7.3 billion US dollars over the next eight years, totaling about 120 billion US dollars by the year 2000. Given the rising prevalence of diabetes, these costs are likely to increase substantially unless countered by better public health or medical interventions.
糖尿病是一种高度流行的疾病,会导致大量发病和过早死亡。我们调查了糖尿病相关的死亡率、残疾、提前退休和旷工如何影响劳动力参与情况。
我们使用了健康与退休研究(HRS),这是1992年一个全国性的51 - 61岁成年人家庭样本作为数据源。
我们对HRS基线数据进行了横断面分析,并使用八年随访数据进行了纵向分析。我们使用两部分回归模型来估计糖尿病对劳动力参与的调整影响,然后估计糖尿病相关生产力损失的经济影响。
糖尿病是生产力损失的一个重要预测因素。到1992年,由于糖尿病导致的生产力损失增加,在平均9.7年的糖尿病病程中达600亿美元。从1992年到2000年,糖尿病导致因提前退休损失收入44亿美元,因病假增加损失0.5亿美元,因残疾损失317亿美元,因过早死亡损失收入220亿美元,生产力损失总计586亿美元,即每年73亿美元。
在美国1931年至1941年出生的成年人群中,糖尿病对经济生产力有深远的负面影响。到1992年,估计与糖尿病相关的生产力损失为600亿美元;在接下来的八年中,每年额外损失平均为73亿美元,到2000年总计约1200亿美元。鉴于糖尿病患病率不断上升,除非通过更好的公共卫生或医疗干预措施加以应对,这些成本可能会大幅增加。