Bishu Kinfe G, Gebregziabher Mulugeta, Dismuke Clara E, Egede Leonard E
Center for Health Disparities Research, Division of General Internal Medicine, Medical University of South Carolina, 135 Rutledge Avenue, MSC 593, Charleston, SC, 29425-0593, USA.
Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA.
J Gen Intern Med. 2015 Dec;30(12):1773-9. doi: 10.1007/s11606-015-3338-y. Epub 2015 May 19.
Although the national cost of missed workdays associated with diabetes has been estimated previously, we use the most recent available national data and methodology to update the individual and national estimates for the U.S population.
We identified 14,429 employed individuals ≥ 18 years of age in 2011 Medical Expenditure Panel Survey (MEPS) data. Diabetes and missed workdays were based on self-report, and cost was based on multiplying the daily wage rate for each individual by the number of missed days. Adjusted total national burden of missed workdays associated with diabetes was calculated using a novel two-part model to simultaneously estimate the association of diabetes with the number and cost of missed workdays.
The unadjusted annual mean 2011 cost of missed workdays was $277 (95 % CI 177.0-378.0) for individuals with diabetes relative to $160 (95 % CI $130-$189) for those without. The incremental cost of missed workdays associated with diabetes was $120 (95 % CI $30.7-$209.1). Based on the US population in 2011, the unadjusted national burden of missed workdays associated with diabetes was estimated to be $2.7 billion, while the fully adjusted incremental national burden was estimated to be $1.1 billion.
We provide more precise estimates of the cost burden of diabetes due to missed workdays on the U.S population. The high incremental and total cost burden of missed workdays among Americans with diabetes suggests the need for interventions to improve diabetes care management among employed individuals.
尽管先前已估算出与糖尿病相关的旷工给国家带来的成本,但我们使用最新可得的全国数据和方法来更新美国人群的个体及全国估算值。
我们在2011年医疗支出小组调查(MEPS)数据中识别出14429名年龄≥18岁的就业个体。糖尿病和旷工情况基于自我报告,成本则通过将每个个体的日工资率乘以旷工天数来计算。使用一种新颖的两部分模型计算与糖尿病相关的旷工调整后全国总负担,以同时估算糖尿病与旷工天数及成本之间的关联。
2011年,糖尿病患者未调整的旷工年均成本为277美元(95%置信区间177.0 - 378.0美元),而无糖尿病者为160美元(95%置信区间130 - 189美元)。与糖尿病相关的旷工增量成本为120美元(95%置信区间30.7 - 209.1美元)。基于2011年美国人口,与糖尿病相关的未调整旷工全国负担估计为27亿美元,而完全调整后的增量全国负担估计为11亿美元。
我们对美国人群中因旷工导致的糖尿病成本负担提供了更精确的估算。美国糖尿病患者旷工的高增量和总成本负担表明需要采取干预措施来改善就业个体的糖尿病护理管理。