Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Providence Health Care, 620-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
Clin Rheumatol. 2011 Mar;30 Suppl 1:S25-32. doi: 10.1007/s10067-010-1637-6. Epub 2011 Mar 2.
Rheumatoid arthritis (RA) not only causes significant morbidity, but also leads to substantial losses in terms of productivity that have a negative impact on the individual and the society. In countries, such as Canada, the US, and the UK, it is known that the costs to the economy in terms of sick leave and work-related disability run into billions of dollars. However, putting an accurate figure on these losses is not entirely straightforward. Most health-related studies use the "human capital" approach, which treats human beings as assets. A figure for lost productivity is calculated by multiplying hours lost by the hourly wage rate. It is a method that is not without its critics because of its emphasis on earning power, which discriminates against non-earners. Another method is the "friction-cost" approach, whereby absenteeism is only recorded if the missed work requires extra hours undertaken, either by the employee himself, or by the others. A third method is the "willingness-to-pay" approach which values life according to an individual's preference to avoid illness with an imputed monetary valuation on the various health outcomes being considered. A number of studies have shown that biologic RA treatments provide productivity benefits in terms of maintaining employment, as well as reducing absenteeism and presenteeism. Going forward, an approach recently adopted by the present authors with encouraging preliminary results, the Valuation of Lost Productivity, takes into account a wide range of factors to provide a measure of productivity that is as accurate as possible.
类风湿关节炎（RA）不仅会导致严重的发病率，还会导致生产力的大量损失，对个人和社会产生负面影响。在加拿大、美国和英国等国家，众所周知，病假和与工作相关的残疾给经济造成的成本高达数十亿美元。然而，要准确确定这些损失并非易事。大多数与健康相关的研究都采用“人力资本”方法，将人类视为资产。通过将损失的工时乘以每小时工资率来计算生产力损失。这种方法并非没有批评者，因为它强调的是赚钱能力，这会歧视非劳动者。另一种方法是“摩擦成本”方法，只有当缺勤需要员工自己或其他人额外工作时，才会记录旷工。第三种方法是“愿意支付”方法，根据个人避免患病的偏好，根据对各种健康结果的估算货币价值来衡量生命价值。多项研究表明，生物 RA 治疗在保持就业方面提供了生产力收益，同时减少了旷工和在职病假。展望未来，本研究作者最近采用了一种令人鼓舞的初步结果的方法，即“损失生产力的估值”，它考虑了广泛的因素，以提供尽可能准确的生产力衡量标准。
