University of Colorado Denver Health Sciences Center, Pharmaceutical Outcomes Research Program, Department of Clinical Pharmacy, School of Pharmacy, 12631 E. 17th Ave., Aurora, CO 80045, USA.
J Rheumatol. 2010 Mar;37(3):544-9. doi: 10.3899/jrheum.081306. Epub 2010 Jan 15.
The Medical Expenditure Panel Survey (MEPS) was used to estimate the national influence of rheumatoid arthritis (RA) on employment, limitations in work or housework, inability to work or do housework, missed work days, days spent sick in bed, and annual wages.
MEPS is a nationally representative survey of the US population. Multiple logistic, negative binomial, and Heckman selection regression methods were used, controlling for age, sex, race, ethnicity, smoking status, income, education, and chronic comorbidity. RA was identified using International Classification of Diseases-9 code 714.
In unadjusted descriptive statistics, individuals with RA were older, had more chronic conditions, missed more work days, spent more days sick in bed, had lower employment rates, had higher rates of limitations and inability to work, and received disability benefits at higher rates. After adjustment, multiple regression analyses showed individuals with RA were 53% less likely to be employed [OR 0.47, 95% CI 0.34-0.65], 3.3 times more likely to have limitations in work or housework (95% CI 2.35-4.64), 2.3 times more likely to be unable to work or do housework (95% CI 1.55-3.53), and spent 3.6 times as many days sick in bed as those without RA (95% CI 2.32-5.53). RA was associated with an expected loss of $8957 in annual earnings (95% CI 1881-15,937 dollars). There was no statistically significant difference in missed work days or the level of wages.
In the most recent available national data for adults, RA was associated with reductions in employment, productivity, and function.
利用医疗支出面板调查(MEPS)评估类风湿关节炎(RA)对就业、工作或家务活动受限、无法工作或做家务、旷工天数、卧床病假天数以及年工资的全国性影响。
MEPS 是一项针对美国人口的全国代表性调查。采用多项逻辑回归、负二项回归和 Heckman 选择回归方法,控制年龄、性别、种族、民族、吸烟状况、收入、教育程度和慢性合并症。RA 采用国际疾病分类第 9 版代码 714 进行识别。
在未经调整的描述性统计中,RA 患者年龄较大,合并症更多,旷工天数更多,卧床病假天数更多,就业率较低,工作或家务活动受限和无法工作的比例更高,领取残疾福利的比例更高。经调整后,多项回归分析显示,RA 患者的就业率降低了 53%[比值比 0.47,95%置信区间 0.34-0.65],工作或家务活动受限的可能性增加了 3.3 倍(95%置信区间 2.35-4.64),无法工作或做家务的可能性增加了 2.3 倍(95%置信区间 1.55-3.53),卧床病假天数是无 RA 患者的 3.6 倍(95%置信区间 2.32-5.53)。RA 预计导致年工资损失 8957 美元(95%置信区间 1881-15937 美元)。旷工天数或工资水平无统计学显著差异。
在最近可获得的成人全国性数据中,RA 与就业、生产力和功能下降相关。