Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia, and Sydney Musculoskeletal Health, The University of Sydney, Camperdown, New South Wales, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Arthritis Care Res (Hoboken). 2023 Mar;75(3):482-490. doi: 10.1002/acr.24886. Epub 2022 Nov 17.
Productivity-adjusted life-years (PALYs) offers a novel approach for quantifying the productivity burden of chronic conditions at the population level over the working lifespan. This study was undertaken to estimate the productivity burden of knee osteoarthritis (KOA) among working-age Australians, defined as lost PALYs and lost gross domestic product (GDP).
A static life-table model was constructed to simulate the experiences of working Australians (between the ages of 15-64 years) with KOA and those without KOA, with follow-up to 65 years (retirement age), a 1-year cycle length, and an annual discount rate of 5%. KOA prevalence data were obtained from the 2019 Global Burden of Diseases, Injuries, and Risk Factors study. Demographic and mortality data were sourced from the Australian Bureau of Statistics. Health utilities and productivity indices were derived from published sources. Population-level losses in years of life, quality-adjusted life-years (QALYs), and PALYs attributable to KOA were estimated by comparing estimates in the KOA cohort to the no KOA cohort.
In 2019, a total of 913,539 working-age Australians were estimated to have KOA, with an overall prevalence of 5.5% (4.5% in men and 6.5% in women). By retirement age, KOA was associated with 39,602 excess deaths, 125,651 years of life lost, 1,938,059 QALYs lost, and 1,943,287 PALYs lost. The economic impact of lost productivity due to KOA amounted to 424 billion Australian dollars in lost GDP.
Our modeling demonstrates a significant economic burden of KOA among the working Australian population, with marked productivity loss. Our findings highlight the need for public health funding and scalable population-level strategies for effective KOA prevention and support to maintain productive working.
生产调整生命年（PALYs）为量化慢性疾病在整个工作寿命期间对人群生产力的负担提供了一种新方法。本研究旨在估计澳大利亚工作年龄段人群膝骨关节炎（KOA）的生产力负担，定义为丧失的 PALYs 和丧失的国内生产总值（GDP）。
构建了一个静态生命表模型，以模拟患有和不患有 KOA 的澳大利亚工作年龄人群（15-64 岁）的经历，随访至 65 岁（退休年龄），周期长度为 1 年，年贴现率为 5%。KOA 的患病率数据来自 2019 年全球疾病、伤害和风险因素研究。人口统计学和死亡率数据来自澳大利亚统计局。健康效用和生产力指数源自已发表的来源。通过将 KOA 队列的估计值与无 KOA 队列的估计值进行比较，估计了 KOA 归因于 KOA 的生命年、质量调整生命年（QALYs）和 PALYs 的人群水平损失。
2019 年，估计有 913,539 名澳大利亚工作年龄人群患有 KOA，总体患病率为 5.5%（男性为 4.5%，女性为 6.5%）。到退休年龄时，KOA 与 39,602 例额外死亡、125,651 年生命损失、1,938,059 QALYs 损失和 1,943,287 PALYs 损失有关。由于 KOA 导致的生产力损失造成的经济影响相当于 4240 亿澳元的 GDP 损失。
我们的模型表明，KOA 在澳大利亚工作人群中造成了巨大的经济负担，生产力损失明显。我们的研究结果强调了公共卫生资金和可扩展的人群水平策略的必要性，以有效预防和支持 KOA，以维持生产力。
