Das Neha, Majumdar Ishani K, Agius Paul A, Lee Peter, Robinson Suzanne, Gao Lan
Deakin Health Economics, School for Health and Social Development, Institute of Health Transformation, Deakin University Melbourne Burwood Campus, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
Deakin Health Economics, School for Health and Social Development, Institute of Health Transformation, Deakin University Melbourne Burwood Campus, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
Soc Sci Med. 2024 Dec;363:117375. doi: 10.1016/j.socscimed.2024.117375. Epub 2024 Oct 3.
Productivity-adjusted life-year (PALY) is a relatively new measure for quantifying the impact of disease on productivity. This study aims to systematically review the productivity factors such as absenteeism and presenteeism among informal caregivers of patients with a wide range of chronic health conditions to inform the PALY quantifications.
A literature search across MEDLINE, Embase, EconLIT, PsychInfo, and CINAHL identified 3578 studies from which a final 23 studies were included in the analysis. To explore the pooled estimate of caregiver absenteeism/presenteeism across diseases and possible drivers, a meta-analysis and meta-regression were conducted using studies where relevant data was available.
The pooled proportion for absenteeism, presenteeism, and work productivity loss (WPL) was 14% (95% Confidence Interval [CI]:9-19%; I = 96.3%), 32% (95% CI:22-42%; I = 98.0%) and 44% (95% CI:35-53%; I = 95.4%) respectively with a high a level of heterogeneity. Factors such as the disease type, and disease severity can influence the caregivers' work productivity.
The data derived in this study will enable the derivation of productivity indices to estimate PALY among caregivers. Future studies can explore the work productivity impact among caregivers of patients with other chronic conditions where they have a significant role but are unexplored, and severity-wise studies in conditions such as stroke and dementia to understand the caregivers' societal productivity impact.
生产力调整生命年(PALY)是一种相对较新的用于量化疾病对生产力影响的指标。本研究旨在系统回顾一系列慢性健康状况患者的非正式照料者旷工和出勤主义等生产力因素,以为PALY量化提供参考。
通过检索MEDLINE、Embase、EconLIT、PsychInfo和CINAHL数据库,共识别出3578项研究,最终纳入23项研究进行分析。为探讨不同疾病照料者旷工/出勤主义的合并估计值及可能的驱动因素,对有相关可用数据的研究进行了荟萃分析和元回归分析。
旷工、出勤主义和工作生产力损失(WPL)的合并比例分别为14%(95%置信区间[CI]:9%-19%;I² = 96.3%)、32%(95% CI:22%-42%;I² = 98.0%)和44%(95% CI:35%-53%;I² = 95.4%),异质性水平较高。疾病类型和疾病严重程度等因素会影响照料者的工作生产力。
本研究得出的数据将有助于推导生产力指数,以估计照料者的PALY。未来的研究可以探索其他慢性病患者照料者的工作生产力影响,这些疾病中照料者发挥着重要作用但尚未得到充分研究,还可以对中风和痴呆等疾病进行按严重程度的研究,以了解照料者对社会生产力的影响。