Eur J Health Econ. 2014 May;15 Suppl 1:S121-8. doi: 10.1007/s10198-014-0603-7. Epub 2014 May 16.
To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD.
Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5%) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases.
The overall DP rate in this IBD population was 32.3%, with partial disability in 24.2%. Of all DP events, 88.8% were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p < 0.001) and CD (RR: 1.74, p < 0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR<35 year olds: 9.4; RR36-40 year olds: 9.4 and 5.6, p < 0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3% patients, respectively, leading to a 28% loss of work productivity and a 32% activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively.
Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.
评估炎症性肠病（IBD）队列中涉及克罗恩病（CD）或溃疡性结肠炎（UC）患者的工作残疾（WD）发生率，并确定与 WD 相关的可能临床或人口统计学因素。据我们所知，这是来自东欧的第一项估计 IBD 间接成本的研究。
纳入了 443 名（M/F：202/241，CD/UC：260/183，平均年龄：35.5（CD）和 40.5（UC）岁，生物药物暴露率为 31.2/11.5%）连续患者的数据。WD 数据通过问卷调查和工作生产力和活动障碍仪器收集。一般人群的残疾抚恤金（DP）率从公共数据库中检索。
该 IBD 人群的总体 DP 率为 32.3%，部分残疾率为 24.2%。所有 DP 事件中，88.8%与 IBD 直接相关。总体而言，与一般人群相比，IBD（RR：1.51，p < 0.001）和 CD（RR：1.74，p < 0.001）的全 DP 更为普遍，与 UC 相比，CD 也更为普遍（OR 1.57，p = 0.03）。只有年轻的 CD 患者的全 DP 风险增加（RR<35 岁：9.4；RR36-40 岁：9.4 和 5.6，p < 0.01）。在 CD 中，年龄组、既往手术、疾病持续时间、频繁复发以及关节炎/关节痛的存在与 DP 风险增加相关。在就业患者中，分别有 25.9%和 60.3%的患者报告缺勤和在职，导致工作生产力损失 28%，活动损失 32%，与疾病活动度和年龄组相关。采用人力资本方法，由于残疾和病假导致的生产力损失的平均成本分别为 1450 欧元和 430 欧元/患者/年（IBD 总生产力损失为 1880 欧元/患者/年），在职人员的生产力损失分别为 2605 欧元（SD=2770 欧元）和 2410 欧元（SD=2970 欧元）/患者/年在 CD 和 UC 中，分别。
年轻的 CD 患者（六到九倍）DP 风险显著增加。既往手术和关节炎/关节痛的存在被确定为 DP 的危险因素。IBD 患者的工作生产力明显受损，与高生产力损失相关。
