Jönsson E, Ornstein P, Goine H, Hedenbro J L
Swedish Social Insurance Agency, Stockholm, Sweden.
Department of Statistics, Uppsala University, Uppsala, Sweden.
Obes Surg. 2017 Sep;27(9):2246-2252. doi: 10.1007/s11695-017-2642-5.
Obesity-related diseases cause costs to society. We studied the cost of work absenteeism before and after gastric bypass and the effects of postoperative diabetes resolution.
Data were obtained from the Scandinavian Obesity Surgery Registry (SOReg) (national coverage >98%) and cross-matched with data from the Social insurance Agency (coverage 100%) for the period ±3 years from operation. In 2010, a total of 7454 bariatric surgeries were performed; the study group is 4971 unique individuals with an annual income of >10,750 Euros and complete data sets. A sex-, age-, and income-matched reference population was identified for comparison.
Patients with obesity had preoperatively a 3.5-fold higher absenteeism. During follow-up (FU), the ratio relative to the reference population remained constant. An increase of 12-14 net absenteeism days was observed in the first 3 months after surgery. Female sex (OR 1.5, CI 1.13-1.8), preoperative anti-depressant use (OR 1.5, CI 1.3-1.9), low income (OR 1.4, CI 1.2-1.8), and a history of sick leave (OR 1.004, CI 1.003-1.004) were associated with increased absenteeism during FU. Diabetes resolution did not decrease absenteeism from preoperative values.
Patients with obesity have higher preoperative absenteeism than the reference population. Operation caused an increase the first 90 days after surgery of 12-13 days. There were no relative increases in absenteeism in the next 3 years; patients did not deviate from preoperative patterns but followed the trend of the reference population. Preoperative diabetes did not elevate that level during FU; diabetes resolution did not lower absenteeism.
肥胖相关疾病给社会带来成本。我们研究了胃旁路手术前后旷工的成本以及术后糖尿病缓解的影响。
数据来自斯堪的纳维亚肥胖手术登记处(SOReg)(全国覆盖率>98%),并与社会保险机构的数据(覆盖率100%)进行交叉匹配,时间范围为手术前后±3年。2010年,共进行了7454例减肥手术;研究组为4971名年收入超过10750欧元且拥有完整数据集的个体。确定了一个性别、年龄和收入匹配的参考人群用于比较。
肥胖患者术前旷工率高3.5倍。在随访期间,相对于参考人群的比例保持不变。术后前3个月观察到净旷工天数增加12 - 14天。女性(比值比1.5,可信区间1.13 - 1.8)、术前使用抗抑郁药(比值比1.5,可信区间1.3 - 1.9)、低收入(比值比1.4,可信区间1.2 - 1.8)和病假史(比值比1.004,可信区间1.003 - 1.004)与随访期间旷工增加有关。糖尿病缓解并未使旷工率低于术前水平。
肥胖患者术前旷工率高于参考人群。手术在术后前90天导致旷工增加12 - 13天。在接下来的3年中旷工率没有相对增加;患者没有偏离术前模式,而是遵循参考人群的趋势。术前糖尿病在随访期间并未提高该水平;糖尿病缓解并未降低旷工率。