Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Pharmacoeconomics. 2024 Aug;42(8):865-877. doi: 10.1007/s40273-024-01402-x. Epub 2024 Jun 14.
Productivity losses are often included in costing studies and economic evaluations to provide a comprehensive understanding of the economic burden of disease. Global guidance on estimating productivity losses is sparse, especially for low-and middle-income countries (LMICs) where informal and unpaid work remains dominant. This study aims to describe current practices for valuing productivity losses in LMICs.
We performed a systematic review of studies published before April 2022 using three databases, including PubMed, Cochrane Library and Web of Science Core Collection. We included any costing or economic evaluation study conducted in a LMIC that provided methodological details on how the monetary value for productivity losses was estimated. Two reviewers independently screened articles for inclusion, extracted data and assessed the quality of the studies.
A total of 281 articles were included. While most studies did not specify the overall approach used to measure and value productivity losses (58%), the human capital approach was the most frequently used approach to measure productivity losses when this was clearly stated (39%). The most common methods to estimate a monetary value for productivity losses were market wages (51%), self-reported wages (28%) and macroeconomic measures (15%).
Reporting standards for productivity losses in LMIC settings have room for improvement. While market wages were the most frequently used method to estimate the monetary value of productivity losses, this relies on context-specific data availability. Until a consensus is reached on if, when and how to include productivity losses in costing and economic evaluation studies, future studies could include a sensitivity analysis to explore the impact of different methods for estimating the monetary value of productivity losses.
生产力损失通常包含在成本效益研究和经济评估中，以全面了解疾病的经济负担。关于估计生产力损失的全球指南很少，尤其是在低中等收入国家（LMICs），那里的非正规和无报酬工作仍然占主导地位。本研究旨在描述 LMICs 中估计生产力损失的当前做法。
我们使用三个数据库（包括 PubMed、Cochrane Library 和 Web of Science Core Collection）对截至 2022 年 4 月之前发表的研究进行了系统回顾。我们纳入了在 LMIC 中进行的任何成本效益研究或经济评估研究，这些研究提供了关于如何估计生产力损失货币价值的方法学细节。两名评审员独立筛选文章是否纳入、提取数据并评估研究质量。
共纳入 281 篇文章。虽然大多数研究没有明确说明用于衡量和评估生产力损失的总体方法（58%），但在明确说明的情况下，人力资本方法是最常用于衡量生产力损失的方法（39%）。用于估计生产力损失货币价值的最常见方法是市场工资（51%）、自我报告的工资（28%）和宏观经济措施（15%）。
在 LMIC 环境中，生产力损失的报告标准还有改进的空间。虽然市场工资是最常用于估计生产力损失货币价值的方法，但这依赖于具体背景的数据可用性。在就是否、何时以及如何在成本效益研究和经济评估研究中纳入生产力损失达成共识之前，未来的研究可以进行敏感性分析，以探讨不同方法估计生产力损失货币价值的影响。
