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在诊断前后一年中,炎症性关节炎和骨关节炎导致的生产力损失成本:一项起始队列研究。

Cost of lost productivity in inflammatory arthritis and osteoarthritis in the year before and after diagnosis: An inception cohort study.

机构信息

Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Int J Rheum Dis. 2024 Jul;27(7):e15252. doi: 10.1111/1756-185X.15252.

Abstract

AIM

Existing studies on the cost of inflammatory arthritis (IA) and osteoarthritis (OA) are often cross-sectional and/or involve patients with various disease durations, thus not providing a comprehensive perspective on the cost of illness from the time of diagnosis. In this study, we therefore assessed the cost of lost productivity in an inception cohort of patients with IA and OA in the year before and after diagnosis.

METHODS

Employment status, monthly income, days absent from work, and presenteeism were collected at diagnosis and 1 year later to estimate the annual costs of unemployment, absenteeism, and presenteeism using human capital approach. Non-parametric bootstrapping was performed to account for the uncertainty of the estimated costs.

RESULTS

Compared to patients with OA (n = 64), patients with IA (n = 102, including 48 rheumatoid arthritis, 19 spondyloarthritis, 23 psoriatic arthritis, and 12 seronegative IA patients) were younger (mean age: 52.3 vs. 59.5 years) with a greater proportion receiving treatment (99.0% vs. 67.2%) and a greater decrease in presenteeism score (median: 15% vs 10%) 1 year after diagnosis. Annual costs of absenteeism and presenteeism were lower in patients with IA than those with OA both in the year before (USD566 vs. USD733 and USD8,472 vs. USD10,684, respectively) and after diagnosis (USD636 vs. USD1,035 and USD6,866 vs. USD9,362, respectively).

CONCLUSION

Both IA and OA impose substantial cost of lost productivity in the year before and after diagnosis. The greater improvement in productivity seen in patients with IA suggests that treatment for IA improves work productivity.

摘要

目的

现有的关于炎症性关节炎(IA)和骨关节炎(OA)的成本研究往往是横断面的,或者涉及各种疾病持续时间的患者,因此无法从诊断时的角度全面了解疾病的成本。因此,在这项研究中,我们评估了 IA 和 OA 患者在诊断前和诊断后一年的生产力损失成本。

方法

在诊断时和 1 年后收集就业状况、月收入、缺勤天数和在职出勤情况,以人力资本法估算失业、缺勤和在职出勤的年成本。采用非参数自举法来解释估计成本的不确定性。

结果

与 OA 患者(n=64)相比,IA 患者(n=102,包括 48 例类风湿关节炎、19 例脊柱关节炎、23 例银屑病关节炎和 12 例血清阴性 IA 患者)年龄更小(平均年龄:52.3 岁 vs. 59.5 岁),接受治疗的比例更高(99.0% vs. 67.2%),1 年后在职出勤评分下降幅度更大(中位数:15% vs. 10%)。IA 患者在诊断前(USD566 与 USD733,USD8472 与 USD10684)和诊断后(USD636 与 USD1035,USD6866 与 USD9362)的缺勤和在职出勤年成本均低于 OA 患者。

结论

IA 和 OA 在诊断前和诊断后都给生产力造成了巨大的损失。IA 患者生产力的改善更大,这表明治疗 IA 可提高工作生产力。

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