系统性红斑狼疮、系统性硬化症和干燥综合征的过度生产力成本：一项基于普通人群的研究。

Excess Productivity Costs of Systemic Lupus Erythematosus, Systemic Sclerosis, and Sjögren's Syndrome: A General Population-Based Study.

机构信息

Arthritis Research Canada, Richmond, and The University of British Columbia, Vancouver, British Columbia, Canada.

Arthritis Research Canada, Richmond, and The University of British Columbia, Vancouver, British Columbia, Canada, and University of Otago, Dunedin, New Zealand.

出版信息

Arthritis Care Res (Hoboken). 2019 Jan;71(1):142-154. doi: 10.1002/acr.23573.

DOI:10.1002/acr.23573

PMID:29648677

Abstract

OBJECTIVE

To determine excess productivity losses and costs of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Sjögren's syndrome (SS) at the population level.

METHODS

Administrative databases from the province of British Columbia, Canada, were used to establish population-based cohorts of SLE, SSc, and SS, and matched comparison cohorts were selected from the general population. Random samples from these cohorts were surveyed about time absent from paid and unpaid work and working at reduced levels/efficiency (presenteeism), using validated labor questionnaires. We estimated excess productivity losses and costs of each diagnosis (over and above nonsystemic autoimmune rheumatic diseases [non-SARDs]), using 2-part models and work disability rates (not employed due to health).

RESULTS

Surveys were completed by 167 SLE, 42 SSc, and 90 SS patients, and by 375 non-SARDs (comparison group) participants. Altogether, predicted excess hours of paid and unpaid work loss were 3.5, 3.2, and 3.4 hours per week for SLE, SSc, and SS patients, respectively. Excess costs were $86, $69, and $84 (calculated as 2015 Canadian dollars) per week, or $4,494, $3,582, and $4,357 per person annually, respectively. Costs for productivity losses from paid work stemmed mainly from presenteeism (SLE = 69% of costs, SSc = 67%, SS = 64%, and non-SARDs = 53%), not from absenteeism. However, many working-age patients were not employed at all, due to health (SLE = 36%, SSc = 32%, SS = 30%, and non-SARDs = 18%), and the majority of total productivity costs were from unpaid work loss (SLE = 73% of costs, SSc = 74%, SS = 60%, and non-SARDs = 47%). Adjusted excess costs from these unpaid production losses were $127, $100, and $82 per week, respectively, among SLE, SSc, and SS patients.

CONCLUSION

In this population-based sample of prevalent SLE, SSc, and SS, lost productivity costs were substantial, mainly from presenteeism and unpaid work impairments.

摘要

目的

确定系统性红斑狼疮（SLE）、系统性硬皮病（SSc）和干燥综合征（SS）在人群层面的超额生产力损失和成本。

方法

利用加拿大不列颠哥伦比亚省的行政数据库，建立 SLE、SSc 和 SS 的人群队列，并从普通人群中选择匹配的对照组。使用经过验证的劳动力问卷，对这些队列中的随机样本进行关于带薪和无薪工作缺勤以及工作效率降低（出勤）的调查。我们使用两部分模型和工作残疾率（因健康原因未就业）来估计每种诊断的超额生产力损失和成本（超过非系统性自身免疫性风湿病[非-SARD]）。

结果

共完成了 167 名 SLE、42 名 SSc 和 90 名 SS 患者以及 375 名非-SARD（对照组）参与者的调查。总的来说，SLE、SSc 和 SS 患者每周预计会损失 3.5、3.2 和 3.4 小时的带薪和无薪工作时间。每周的超额成本分别为 86、69 和 84 加元（按 2015 年加元计算），或每年每人分别为 4494、3582 和 4357 加元。带薪工作生产力损失的成本主要来自出勤（SLE = 69%的成本，SSc = 67%，SS = 64%，非-SARDs = 53%），而不是缺勤。然而，许多处于工作年龄的患者由于健康原因根本没有就业（SLE = 36%，SSc = 32%，SS = 30%，非-SARDs = 18%），并且大部分总生产力成本来自无薪工作损失（SLE = 73%的成本，SSc = 74%，SS = 60%，非-SARDs = 47%）。SLE、SSc 和 SS 患者每周的这些无薪生产损失的调整后超额成本分别为 127、100 和 82 加元。