Department of Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
Qual Life Res. 2013 Nov;22(9):2307-14. doi: 10.1007/s11136-013-0364-2. Epub 2013 Feb 8.
A novel indicator called health-adjusted leave days (HALDs) is proposed. It integrates the opposite level of health-related quality of life (HRQoL) with the sick leave days (LDs) before return-to-work (RTW) to better measure the impact of injuries on occupational health.
A total of 1,167 limb injuries were consecutively recruited in a teaching hospital from January to December 2009. The number of LDs was calculated between the date of injury and the first episode of RTW. Each subject was repeatedly assessed with EuroQol instrument (EQ-5D) before RTW. The HRQoL index is defined as 1 minus the EQ-5D utility and re-scaled to 0-1 range to reflect the impact of injuries. The expected HALD of each group is calculated by integrating the product of the proportion of non-RTW function and the mean HRQoL index function over the days followed up to 2 years for the group. We compared the expected HALDs between subgroups according to various demographic characteristics and consequences of injury.
Older and female workers tended to have longer LDs than men and younger workers, with an increase in percentage change of 16.0 or 139.5 %, respectively. After adjusting for HRQoL index, the percentages for HALDs were changed to 28.7 or 186.6 %, respectively. The percentages for the less-educated workers and blue collar workers were 185.7 and 155.8 %. The expected HALDs showed statistical significant differences in all subgroup analyses.
We believed that the proposed HALD could better measure the impact of injuries and is potentially useful for the clinical decision and industrial policy-making with respect to the assessment of the importance of limb injury due to a worker's sick leaves.
提出了一个新的指标，称为健康调整的休假天数（HALD）。它将与健康相关的生活质量（HRQoL）的相反水平与重返工作岗位（RTW）前的病假天数（LDs）相结合，以更好地衡量伤病对职业健康的影响。
2009 年 1 月至 12 月，一家教学医院连续收治了 1167 例肢体损伤患者。LDs 的计算时间为受伤日期与首次 RTW 之间的时间。每位患者在 RTW 前均接受了欧洲五维健康量表（EQ-5D）的重复评估。HRQoL 指数定义为 1 减去 EQ-5D 效用，并重新调整为 0-1 范围，以反映损伤的影响。通过将每个组在随访的 2 年内的非 RTW 功能比例与平均 HRQoL 指数函数的乘积进行积分，计算出每个组的预期 HALD。根据各种人口统计学特征和损伤后果，比较了亚组之间的预期 HALD。
与男性和年轻工人相比，年龄较大和女性工人的 LDs 往往更长，分别增加了 16.0%或 139.5%。调整 HRQoL 指数后，HALD 的百分比分别变为 28.7%或 186.6%。受教育程度较低和蓝领工人的百分比分别为 185.7%和 155.8%。所有亚组分析均显示预期 HALD 存在统计学显著差异。
我们认为，所提出的 HALD 可以更好地衡量伤病的影响，对于评估工人因病假而导致的肢体损伤的重要性，在临床决策和工业政策制定方面具有潜在的应用价值。
