Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
Acta Neurol Scand. 2018 Dec;138(6):490-499. doi: 10.1111/ane.13001. Epub 2018 Jul 24.
The economic situation of individuals diagnosed with multiple sclerosis (MS) is under studied, with the levels and sources of incomes suggested to vary with socio-demographics. We aimed to describe the diversity of disposable income (DI) trajectories among working-aged individuals with incident MS, and investigate the associations of socio-demographic characteristics with identified trajectories.
MATERIALS & METHODS: A population-based cohort study of all 1528 individuals first diagnosed with MS in 2008-2009 when aged 25-59, with data linked from three nationwide Swedish registers. DI was defined as net earnings plus net income from benefits. Trajectories of mean annual DI from 7 years prior to 4 years after diagnosis were identified by group-based trajectory modelling. An individual's group membership was determined by individual model-fit estimates from a multinomial logit function. Chi-squared tests and multinomial logistic regressions estimated the associations between trajectory membership and socio-demographic (sex, age, education, birth country, type of living area and family situation) and work disability (sickness absence and disability pension) characteristics.
Seven distinct DI trajectories were identified: two consistently low (50.7% of individuals); four increasing (39.0%); and one decreasing (10.3%). Socio-demographic and work disability characteristics were associated with trajectories; the increasing trajectories had older age-profiles and higher proportions of men, while university education was less common in the consistently low trajectories.
We identified high diversity in DI development within the cohort around MS diagnosis. Socio-demographic and work disability characteristics differed between the trajectories. This broader information of the economic situation is important to convey to patients.
多发性硬化症(MS)患者的经济状况研究较少,其收入水平和来源据推测因社会人口统计学特征而异。我们旨在描述处于工作年龄段的初诊 MS 患者的可支配收入(DI)轨迹多样性,并探讨社会人口统计学特征与已确定轨迹的关联。
本研究是一项基于人群的队列研究,纳入了所有于 2008-2009 年年龄在 25-59 岁时首次被诊断为 MS 的 1528 例患者,数据来源于三个全国性的瑞典登记处。DI 被定义为净收入加福利净收入。通过基于群组的轨迹建模,确定了从诊断前 7 年到后 4 年的平均年度 DI 轨迹。个体的分组归属通过多项逻辑回归函数的个体模型拟合估计值确定。卡方检验和多项逻辑回归用于估计轨迹成员与社会人口统计学(性别、年龄、教育程度、出生地、居住地区类型和家庭状况)和工作残疾(病假和残疾抚恤金)特征之间的关联。
共确定了七种不同的 DI 轨迹:两种持续较低(50.7%的个体);四种递增(39.0%);一种递减(10.3%)。社会人口统计学和工作残疾特征与轨迹相关;递增轨迹的年龄分布较老,男性比例较高,而持续较低轨迹的人群中接受过大学教育的比例较低。
我们在 MS 诊断前后的队列中发现了 DI 发展的高度多样性。轨迹之间的社会人口统计学和工作残疾特征存在差异。将这种更广泛的经济状况信息传达给患者非常重要。