Health Services Research Unit, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain.
Mol Psychiatry. 2011 Dec;16(12):1234-46. doi: 10.1038/mp.2010.101. Epub 2010 Oct 12.
Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental Health (WMH) surveys. Face-to-face interviews were carried out with 62 971 respondents (72.0% pooled response rate). Presence of ten chronic physical disorders and nine mental disorders was assessed for each respondent along with information about the number of days in the past month each respondent reported being totally unable to work or carry out their other normal daily activities because of problems with either physical or mental health. Multiple regression analysis was used to estimate associations of specific conditions and comorbidities with days out of role, controlling by basic socio-demographics (age, gender, employment status and country). Overall, 12.8% of respondents had some day totally out of role, with a median of 51.1 a year. The strongest individual-level effects (days out of role per year) were associated with neurological disorders (17.4), bipolar disorder (17.3) and post-traumatic stress disorder (15.2). The strongest population-level effect was associated with pain conditions, which accounted for 21.5% of all days out of role (population attributable risk proportion). The 19 conditions accounted for 62.2% of all days out of role. Common health conditions, including mental disorders, make up a large proportion of the number of days out of role across a wide range of countries and should be addressed to substantially increase overall productivity.
由于健康问题而缺勤的天数是人力资本流失的主要原因。我们研究了在参与世界卫生组织(WHO)世界心理健康(WMH)调查的 24 个国家中,常见的身体和精神障碍在缺勤天数中所占的相对重要性。对 62971 名受访者(72.0%的汇总响应率)进行了面对面访谈。对每位受访者评估了十种慢性身体疾病和九种精神疾病的存在情况,并提供了有关受访者在过去一个月中因身体或心理健康问题而完全无法工作或开展其他正常日常活动的天数信息。使用多元回归分析来估计特定疾病和合并症与缺勤天数之间的关联,同时控制基本社会人口统计学因素(年龄、性别、就业状况和国家)。总体而言,12.8%的受访者有一些天完全缺勤,中位数为每年 51.1 天。与缺勤天数相关的个体水平最强的影响因素(每年缺勤天数)与神经系统疾病(17.4)、双相情感障碍(17.3)和创伤后应激障碍(15.2)有关。与疼痛状况相关的人群水平最强的影响因素,占所有缺勤天数的 21.5%(人群归因风险比例)。这 19 种疾病占所有缺勤天数的 62.2%。常见的健康状况,包括精神障碍,在广泛的国家中占据了很大一部分缺勤天数,应加以解决,以大幅提高整体生产力。