Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan.
Cancer Med. 2018 Mar;7(3):736-745. doi: 10.1002/cam4.1371. Epub 2018 Feb 23.
A "health shock," that is, a large, unanticipated adverse health event, can have long-term financial implications for patients and their families. Colorectal cancer is the third most commonly diagnosed cancer among men and women and is an example of a specific health shock. We examined whether specific benefits (employer-based health insurance, paid sick leave, extended sick leave, unpaid time off, disability benefits) are associated with job retention after diagnosis and treatment of colorectal cancer. In 2011-14, we surveyed patients with Stage III colorectal cancer from two representative SEER registries. The final sample was 1301 patients (68% survey response rate). For this study, we excluded 735 respondents who were not employed and 20 with unknown employment status. The final analytic sample included 546 respondents. Job retention in the year following diagnosis was assessed, and multivariable logistic regression was used to evaluate associations between job retention and access to specific employment benefits. Employer-based health insurance (OR = 2.97; 95% CI = 1.56-6.01; P = 0.003) and paid sick leave (OR = 2.93; 95% CI = 1.23-6.98; P = 0.015) were significantly associated with job retention, after adjusting for sociodemographic, clinical, geographic, and job characteristics.
“健康冲击”，即重大的、意料之外的健康事件，可能会对患者及其家庭的财务状况产生长期影响。结直肠癌是男性和女性中第三常见的癌症，是特定健康冲击的一个例子。我们研究了在诊断和治疗结直肠癌后，特定福利（雇主提供的健康保险、带薪病假、延长病假、无薪休假、残疾福利）是否与保留工作有关。2011-14 年，我们对来自两个代表性 SEER 登记处的 III 期结直肠癌患者进行了调查。最终样本为 1301 名患者（68%的调查应答率）。在这项研究中，我们排除了 735 名未就业的受访者和 20 名就业状况未知的受访者。最终分析样本包括 546 名受访者。评估了诊断后一年内的工作保留情况，并使用多变量逻辑回归评估了工作保留与获得特定就业福利之间的关系。雇主提供的健康保险（OR=2.97；95%CI=1.56-6.01；P=0.003）和带薪病假（OR=2.93；95%CI=1.23-6.98；P=0.015）与工作保留显著相关，调整了社会人口统计学、临床、地理和工作特征后。
