Joish Vijay N, Donaldson Gary, Stockdale William, Oderda Gary M, Crawley Joseph, Sasane Rahul, Joshua-Gotlib Sandra, Brixner Diana I
Pharmacotherapy Outcomes Research Center, University of Utah College of Pharmacy, Salt Lake City, UT, USA.
Curr Med Res Opin. 2005 Apr;21(4):535-44. doi: 10.1185/030079905X38240.
The objective of this study was to examine the relationship of work loss associated with gastro- the relationship of work loss associated with gastro- the relationship of work loss associated with gastro-esophageal reflux disease (GERD) and peptic ulcer disease (GERD) and peptic ulcer disease (PUD) in a large population of employed individuals in the United States (US) and quantify the individuals in the United States (US) and quantify the economic impact of these diseases to the employer.
A proprietary database that contained work place absence, disability and workers' compensation data in addition to prescription drug and medical claims was used to answer the objectives. Employees with a medical claim with an ICD-9 code for GERD or PUD were identified from 1 January 1997 to 31 December 2000. A cohort of controls was identified for the same time period using the method of frequency matching on age, gender, industry type, occupational status, and employment status. Work absence rates and health care costs were compared between the groups after adjusting for demo graphic, and employment differences using analysis of covariance models.
There were significantly lower (p < 0.05) prescription, and outpatient costs in the controls compared to the disease groups, although the eta-square values were very low. The mean work absence attributed to sick days was 2.8 (+/- 2.3) for controls, 3.4 (+/- 2.5) for GERD, 3.2 (+/- 2.6) for PUD, and 3.2 (+/- 2.3) days for GERD + PUD. For work loss, a significantly higher (p < 0.05) rate of adjusted all-cause absenteeism and sickness-related absenteeism were observed between the disease groups versus the controls. In particular, controls had an average of 1.2 to 1.6 days and 0.4 to 0.6 lower all-cause and sickness-related absenteeism compared to the disease groups. The incremental economic impact projected to a hypothetical employed population was estimated to be $3441 for GERD, $1374 for PUD, and $4803 for GERD + PUD per employee per year compared to employees without these diseases.
Direct medical cost and work absence in employees with GERD, PUD and GERD + PUD represent a significant burden to employees and employers.
本研究的目的是在美国大量就业人群中考察与胃食管反流病（GERD）和消化性溃疡病（PUD）相关的工作损失情况，并量化这些疾病对雇主造成的经济影响。
使用一个专有数据库来实现研究目的，该数据库除了包含处方药和医疗理赔数据外，还包含工作场所缺勤、残疾和工伤赔偿数据。从1997年1月1日至2000年12月31日，识别出具有GERD或PUD的ICD - 9编码医疗理赔的员工。在同一时期，采用年龄、性别、行业类型、职业状况和就业状况频率匹配的方法确定一组对照人群。使用协方差分析模型对人口统计学和就业差异进行调整后，比较两组之间的缺勤率和医疗保健成本。
与疾病组相比，对照组的处方药和门诊费用显著更低（p < 0.05），尽管eta平方值非常低。对照组因病假导致的平均缺勤天数为2.8（±2.3）天，GERD组为3.4（±2.5）天，PUD组为3.2（±2.6）天，GERD + PUD组为3.2（±2.3）天。在工作损失方面，疾病组与对照组相比，经调整的全因缺勤率和与疾病相关的缺勤率显著更高（p < 0.05）。特别是，与疾病组相比，对照组的全因缺勤和与疾病相关的缺勤平均分别低1.2至1.6天和0.4至0.6天。与没有这些疾病的员工相比，预计假设的就业人群中，GERD每名员工每年的增量经济影响为3441美元，PUD为1374美元，GERD + PUD为4803美元。
GERD、PUD以及GERD + PUD员工的直接医疗成本和工作缺勤对员工和雇主而言都是重大负担。
