a National Center on Birth Defects and Developmental Disabilities , Centers for Disease Control and Prevention , Atlanta , GA , USA.
b John Ward Economics , Prairie Village , KS , USA.
J Med Econ. 2019 Jun;22(6):501-508. doi: 10.1080/13696998.2018.1542520. Epub 2018 Nov 15.
Human-capital based lifetime productivity estimates are frequently used in cost-of-illness (COI) analyses and, less commonly, in cost-effectiveness analyses (CEAs). Previous US estimates assumed that labor productivity and real earnings both grow by 1% per year. This study presents estimates of annual and lifetime productivity for 2016 using data from the American Community Survey, the American Time Use Survey, and the Current Population Survey, and with varying assumptions about real earnings growth. The sum of market productivity (gross annual personal labor earnings adjusted for employer-paid benefits) and the imputed value of non-market time spent in household, caring, and volunteer services was estimated. The present value of lifetime productivity at various ages was calculated for synthetic cohorts using annual productivity estimates, life tables, discount rates, and assumptions about future earnings growth rates. Mean annual productivity was $57,324 for US adults in 2016, including $36,935 in market and $20,389 in non-market productivity. Lifetime productivity at birth, using a 3% discount rate, is roughly $1.5 million if earnings grow by 1% per year and $1.2 million if future earnings growth averages 0.5% per year. Inclusion of avoidable productivity losses in societal-perspective CEAs of health interventions is recommended in new US cost-effectiveness guidelines. However, estimates vary depending on whether analysts choose to estimate total productivity or just market productivity, and on assumptions made about growth in future productivity and earnings.
基于人力资本的终身生产力估计常用于疾病成本(COI)分析,较少用于成本效益分析(CEA)。以前美国的估计假设劳动生产力和实际收入每年增长 1%。本研究使用美国社区调查、美国时间使用调查和当前人口调查的数据,对 2016 年的年度和终身生产力进行了估计,并对实际收入增长的假设进行了不同的假设。市场生产力(雇主支付福利调整后的年度个人劳动收入)和家庭、护理和志愿服务中非市场时间的估算价值之和进行了估算。使用年度生产力估计、生命表、贴现率和未来收益增长率假设,为综合队列计算了不同年龄的终身生产力的现值。2016 年,美国成年人的平均年生产力为 57324 美元,其中市场生产力为 36935 美元,非市场生产力为 20389 美元。如果未来收益每年增长 1%,使用 3%的贴现率,那么出生时的终身生产力约为 150 万美元,如果未来收益平均每年增长 0.5%,则为 120 万美元。建议在美国新的成本效益指南中,在考虑健康干预措施的社会视角的 CEA 时,纳入可避免的生产力损失。然而,估计值取决于分析师是选择估计总生产力还是仅市场生产力,以及对未来生产力和收益增长的假设。