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Published in: The European Journal of Health Economics 1/2014

01-05-2014 | Original Paper

Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics

Authors: Mandel D. Michael, Anita Bálint, Barbara D. Lovász, László Gulácsi, Bálint Strbák, Petra A. Golovics, Klaudia Farkas, Zsuzsanna Kürti, Blanka K. Szilágyi, Anna Mohás, Tamás Molnár, Péter L. Lakatos

Published in: The European Journal of Health Economics | Special Issue 1/2014

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Abstract

Background and aims

To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn’s disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD.

Methods

Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5 %) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases.

Results

The overall DP rate in this IBD population was 32.3 %, with partial disability in 24.2 %. Of all DP events, 88.8 % were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p < 0.001) and CD (RR: 1.74, p < 0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR<35 year olds: 9.4; RR36–40 year olds: 9.4 and 5.6, p < 0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3 % patients, respectively, leading to a 28 % loss of work productivity and a 32 % activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively.

Conclusion

Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.
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Metadata
Title
Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics
Authors
Mandel D. Michael
Anita Bálint
Barbara D. Lovász
László Gulácsi
Bálint Strbák
Petra A. Golovics
Klaudia Farkas
Zsuzsanna Kürti
Blanka K. Szilágyi
Anna Mohás
Tamás Molnár
Péter L. Lakatos
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue Special Issue 1/2014
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-014-0603-7

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