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由于优先级条件导致美国雇主的生产力损失和生产力损失成本:系统评价。

Productivity loss and productivity loss costs to United States employers due to priority conditions: a systematic review.

机构信息

Health Economics and Market Access, Boston Scientific, Marlborough, MA, USA.

Health Services Consulting Corporation, Boxborough, MA, USA.

出版信息

J Med Econ. 2023 Jan-Dec;26(1):262-270. doi: 10.1080/13696998.2023.2172282.

Abstract

AIMS

To summarize published studies evaluating productivity loss and productivity loss costs associated with cancer, chronic lung disease, depression, pain, and cardiometabolic disease among US employees.

MATERIALS AND METHODS

A PubMed search from the past 10 years was conducted using the terms productivity, absenteeism, presenteeism, cancer, bronchitis, asthma, chronic obstructive pulmonary disease, depression, pain, heart disease, hypertension, and diabetes (limited to English-language publications and studies of adults aged 19-64). Study endpoints included annual incremental time (work hours lost and Work Productivity and Impairment [WPAI] questionnaire overall work impairment) and monetary estimates of productivity loss. Studies were critically appraised using a modified Oxford Centre for Evidence-Based Medicine (OCEBM) Quality Rating Scheme.

RESULTS

Of 2,037 records identified from the search, 183 studies were included. The most common observed condition leading to productivity loss was pain (24%), followed by cancer (22%), chronic lung disease (17%), cardiometabolic disease (16%), and depression (16%). Nearly three-quarters of the studies ( = 133, 72.7%) were case-control/retrospective cohort studies (OCEBM quality rating 3); the remainder were case series/cross-sectional studies ( = 28, 15.3%; quality rating 4), randomized clinical trials ( = 18, 9.8%; quality rating 1); and controlled trials without randomization/prospective comparative cohort trials ( = 4, 2.2%; quality rating 2). Samples sizes ranged from 18 patients to millions of patients for studies using the Medical Expenditure Panel Survey (MEPS). Most studies found employees lost up to 80 annual incremental work hours; employees with cancer and cardiometabolic disease had the greatest number of work hours lost. Overall percentage work impairment ranged from 10% to 70% and was higher for pain and depression. Annual incremental costs of lost work productivity ranged from $100 to $10,000 and were higher for cancer, pain, and depression.

LIMITATIONS

Study heterogeneity.

CONCLUSIONS

Despite some gaps in evidence for the cost of productivity loss, sufficient data highlight the substantial employer burden of lost productivity among priority conditions.

摘要

目的

总结评估美国员工癌症、慢性肺部疾病、抑郁、疼痛和心血管代谢疾病导致的生产力损失和生产力损失成本的已发表研究。

材料与方法

通过在 PubMed 上进行过去 10 年的检索,使用术语“生产力、旷工、出勤主义、癌症、支气管炎、哮喘、慢性阻塞性肺病、抑郁、疼痛、心脏病、高血压和糖尿病”(仅限于英语出版物和 19-64 岁成年人的研究)进行搜索。研究终点包括每年的增量时间(工作时间损失和工作生产力和损伤[WPAI]问卷整体工作损伤)和生产力损失的货币估计。使用改良的牛津循证医学中心(OCEBM)质量评级方案对研究进行了严格评估。

结果

从搜索中确定了 2037 条记录,其中 183 项研究被纳入。导致生产力损失最常见的观察到的疾病是疼痛(24%),其次是癌症(22%)、慢性肺部疾病(17%)、心血管代谢疾病(16%)和抑郁(16%)。近四分之三的研究( = 133,72.7%)为病例对照/回顾性队列研究(OCEBM 质量评分 3);其余为病例系列/横断面研究( = 28,15.3%;质量评分 4)、随机临床试验( = 18,9.8%;质量评分 1)和无随机分组/前瞻性比较队列试验的对照试验( = 4,2.2%;质量评分 2)。使用医疗支出面板调查(MEPS)的研究样本量从 18 名患者到数百万名患者不等。大多数研究发现员工每年损失多达 80 个工作小时;患有癌症和心血管代谢疾病的员工损失的工作时间最多。整体工作损伤百分比范围为 10%至 70%,疼痛和抑郁的比例更高。失去工作生产力的年度增量成本从 100 美元到 10000 美元不等,癌症、疼痛和抑郁的成本更高。

局限性

研究的异质性。

结论

尽管生产力损失成本的证据存在一些差距,但足够的数据突显了优先条件下雇主因生产力损失而承受的巨大负担。

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