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[工作更长久,身体更健康?基于医疗保险理赔数据的就业人群和普通人群中心血管疾病和肌肉骨骼疾病无病生存年数的趋势]

[Healthier at work for longer? Trends in life years free of cardiovascular and musculoskeletal diseases in the employed and general population based on health insurance claims data].

作者信息

Tetzlaff Juliane, Epping Jelena

机构信息

Medizinische Soziologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Niedersachsen, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 May;67(5):555-563. doi: 10.1007/s00103-024-03868-8. Epub 2024 Apr 12.

Abstract

BACKGROUND

Our study focuses on the development of disease-free life years of two disease groups with high public health relevance: musculoskeletal diseases (MSD) and cardiovascular diseases (CVD). Against the backdrop of prolonged working lives, the development of disease-free life years in the working-age population is compared with the trend in the employed population. Differences between occupational groups are also examined.

METHODS

The study is based on data from the statutory health insurance provider AOK Lower Saxony (N = 2,001,225). Incident cases were identified based on the diagnosis data. The expected years free of MSD and CVD were calculated using multistate life table analysis for three periods between 2006 and 2018. The occupational group is identified via the occupational key. Three groups are distinguished: unskilled and semi-skilled workers, skilled workers and specialists, and highly skilled workers.

RESULTS

Life years free of MSD clearly decreased in the general population and among the employed population. The decrease was strongest in the higher-skilled occupational groups. Life years free of CVD increased in the general population. The increase was weaker among the employed population. The only occupational group showing increases were men in unskilled and semi-skilled occupations.

DISCUSSION

The study shows that disease-free life years among employed persons developed in some cases worse than in the general population. For the analysed disease groups MSD and CVD, there are clear inequalities between occupational groups, which decreased somewhat over time. The inequalities and the decrease in years free of MSD highlight the high public health relevance and the need for effective prevention strategies to prevent CVD and MSD in working age.

摘要

背景

我们的研究聚焦于两个具有高度公共卫生相关性的疾病组的无病生存年数发展情况:肌肉骨骼疾病(MSD)和心血管疾病(CVD)。在工作寿命延长的背景下,将劳动年龄人口的无病生存年数发展情况与就业人口的趋势进行比较。同时也研究职业群体之间的差异。

方法

该研究基于下萨克森州法定健康保险提供商AOK的数据(N = 2,001,225)。根据诊断数据确定新发病例。使用多状态生命表分析法计算2006年至2018年三个时期无MSD和CVD的预期年数。通过职业代码确定职业群体。分为三组:非技术和半技术工人、技术工人和专家以及高技能工人。

结果

普通人群和就业人群中无MSD的生存年数明显减少。在高技能职业群体中减少最为明显。普通人群中无CVD的生存年数增加。就业人群中的增加幅度较小。唯一显示增加的职业群体是非技术和半技术职业的男性。

讨论

该研究表明,就业人员的无病生存年数在某些情况下比普通人群更差。对于所分析的疾病组MSD和CVD,职业群体之间存在明显的不平等,且随着时间的推移有所减少。无MSD年数的不平等和减少凸显了其高度的公共卫生相关性以及在工作年龄预防CVD和MSD的有效预防策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a75a/11093846/cea2f8911983/103_2024_3868_Fig1_HTML.jpg

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