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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

The economic impact of diabetes through lost labour force participation on individuals and government: evidence from a microsimulation model

Authors: Deborah Schofield, Michelle M Cunich, Rupendra N Shrestha, Megan E Passey, Lennert Veerman, Emily J Callander, Simon J Kelly, Robert Tanton

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Diabetes is a costly and debilitating disease. The aim of the study is to quantify the individual and national costs of diabetes resulting from people retiring early because of this disease, including lost income; lost income taxation, increased government welfare payments; and reductions in GDP.

Methods

A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the economic costs of early retirement due to diabetes. The study included all Australians aged 45–64 years in 2010 based on Australian Bureau of Statistics’ Surveys of Disability, Ageing and Carers. A multiple regression model was used to identify significant differences in income, government welfare payments and taxation liabilities between people out of the labour force because of their diabetes and those employed full time with no chronic health condition.

Results

The median annual income of people who retired early because of their diabetes was significantly lower (AU$11 784) compared to those employed full time without a chronic health condition who received almost five times more income. At the national level, there was a loss of AU$384 million in individual earnings by those with diabetes, an extra AU$4 million spent in government welfare payments, a loss of AU$56 million in taxation revenue, and a loss of AU$1 324 million in GDP in 2010: all attributable to diabetes through its impact on labour force participation. Sensitivity analysis was used to assess the impact of different diabetes prevalence rates on estimates of lost income, lost income taxation, increased government welfare payments, and reduced GDP.

Conclusions

Individuals bear the cost of lost income in addition to the burden of the disease. The Government endures the impacts of lost productivity and income taxation revenue, as well as spending more in welfare payments. These national costs are in addition to the Government’s direct healthcare costs.
Literature
2.
go back to reference Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Christopher JL, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, AlMazroa MA, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez M-G, Baxter A, et al: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012, 380 (9859): 2197-2223. 10.1016/S0140-6736(12)61689-4.CrossRefPubMed Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Christopher JL, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, AlMazroa MA, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez M-G, Baxter A, et al: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012, 380 (9859): 2197-2223. 10.1016/S0140-6736(12)61689-4.CrossRefPubMed
3.
go back to reference Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, AlMazroa MA, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Abdulhak AB, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, et al: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012, 380 (9859): 2095-2128. 10.1016/S0140-6736(12)61728-0.CrossRefPubMed Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, AlMazroa MA, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Abdulhak AB, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, et al: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012, 380 (9859): 2095-2128. 10.1016/S0140-6736(12)61728-0.CrossRefPubMed
4.
go back to reference Lavigne JE, Phelps CE, Mushlin A, Lednar WM: Reductions in individual work productivity associated with type 2 diabetes mellitus. Pharmacoeconomics. 2003, 21 (15): 1123-1134. 10.2165/00019053-200321150-00006.CrossRefPubMed Lavigne JE, Phelps CE, Mushlin A, Lednar WM: Reductions in individual work productivity associated with type 2 diabetes mellitus. Pharmacoeconomics. 2003, 21 (15): 1123-1134. 10.2165/00019053-200321150-00006.CrossRefPubMed
5.
go back to reference Colagiuri S, Colagiuri R, Conway B, Grainger D, Davey P: DiabCost Australia: Assessing the burden of Type 2 Diabetes in Australia. 2002, Canberra: Diabetes Australia Colagiuri S, Colagiuri R, Conway B, Grainger D, Davey P: DiabCost Australia: Assessing the burden of Type 2 Diabetes in Australia. 2002, Canberra: Diabetes Australia
6.
go back to reference Australian Institute of Health and Welfare: Australia’s Health, 2010. 2010, Canberra: AIHW Australian Institute of Health and Welfare: Australia’s Health, 2010. 2010, Canberra: AIHW
7.
go back to reference Goss J: Projection of Australian health care expenditure by disease, 2003 to 2033. Cat. no. HWE 43. 2008, Canberra: Australian Institute of Health and Welfare Goss J: Projection of Australian health care expenditure by disease, 2003 to 2033. Cat. no. HWE 43. 2008, Canberra: Australian Institute of Health and Welfare
8.
go back to reference Australian Institute of Health and Welfare: Health system expenditure on disease and injury in Australia. 2010, Canberra: AIHW Australian Institute of Health and Welfare: Health system expenditure on disease and injury in Australia. 2010, Canberra: AIHW
9.
go back to reference Kraut A, Tate R, Walld R, Mustard C: Impact of diabetes on employment income in Manitoba, Canada. Diabetes Care. 2001, 24 (1): 64-68. 10.2337/diacare.24.1.64.CrossRefPubMed Kraut A, Tate R, Walld R, Mustard C: Impact of diabetes on employment income in Manitoba, Canada. Diabetes Care. 2001, 24 (1): 64-68. 10.2337/diacare.24.1.64.CrossRefPubMed
10.
go back to reference Schofield DJ, Shrestha RN, Passey ME, Earnest A, Fletcher SL: Chronic disease and labour force participation among older Australians. Med J Australia. 2008, 189 (8): 447-450.PubMed Schofield DJ, Shrestha RN, Passey ME, Earnest A, Fletcher SL: Chronic disease and labour force participation among older Australians. Med J Australia. 2008, 189 (8): 447-450.PubMed
13.
go back to reference Costello P: Intergenerational report 2007. 2007, Canberra: Commonwealth of Australia Costello P: Intergenerational report 2007. 2007, Canberra: Commonwealth of Australia
16.
go back to reference Australian Bureau of Statistics: Information Paper - Basic Confidentialised Unit Record File: Survey of Disability, Ageing and Carers 2003 (reissue). 2005, Canberra: Australian Bureau of Statistics Australian Bureau of Statistics: Information Paper - Basic Confidentialised Unit Record File: Survey of Disability, Ageing and Carers 2003 (reissue). 2005, Canberra: Australian Bureau of Statistics
17.
go back to reference Australian Bureau of Statistics: Information Paper: Disability, Ageing and Carers, Australia: User Guide 2009. 2011, Canberra: Australian Bureau of Statistics Australian Bureau of Statistics: Information Paper: Disability, Ageing and Carers, Australia: User Guide 2009. 2011, Canberra: Australian Bureau of Statistics
18.
go back to reference Schofield D, Percival R, Passey M, Shrestha R, Callander E, Kelly S: The financial vulnerability of individuals with diabetes. Br J Diabetes Vasc Dis. 2010, 10 (6): 300-304. 10.1177/1474651410385864.CrossRef Schofield D, Percival R, Passey M, Shrestha R, Callander E, Kelly S: The financial vulnerability of individuals with diabetes. Br J Diabetes Vasc Dis. 2010, 10 (6): 300-304. 10.1177/1474651410385864.CrossRef
19.
go back to reference Smith P, Chen C, Mustard C, Bielecky A, Beaton D, Ibraham S: Examining the relationship between chronic conditions, multi‒morbidity and labour market participation in Canada: 2000–2005. Ageing and Society. 2013, doi 10.1017/S0144686X13000457. Available from: http://www.iwh.on.ca/biblio/884 Smith P, Chen C, Mustard C, Bielecky A, Beaton D, Ibraham S: Examining the relationship between chronic conditions, multi‒morbidity and labour market participation in Canada: 2000–2005. Ageing and Society. 2013, doi 10.1017/S0144686X13000457. Available from: http://​www.​iwh.​on.​ca/​biblio/​884
20.
go back to reference Singh AC, Mohl CA: Understanding calibration estimators in survey sampling. Survey Methodology. 1996, 22: 107-115. Singh AC, Mohl CA: Understanding calibration estimators in survey sampling. Survey Methodology. 1996, 22: 107-115.
21.
go back to reference Tanton R, Vidyattama Y, Nepal B, McNamara J: Small area estimation using a reweighting algorithm. J R Statist Soc A. 2011, 174 (4): 931-951. 10.1111/j.1467-985X.2011.00690.x.CrossRef Tanton R, Vidyattama Y, Nepal B, McNamara J: Small area estimation using a reweighting algorithm. J R Statist Soc A. 2011, 174 (4): 931-951. 10.1111/j.1467-985X.2011.00690.x.CrossRef
22.
go back to reference Rässler S: Statistical matching: A frequentist theory, practical applications, and alternative Bayesian approaches. 2002, New York: Springer-Verlag New York, IncCrossRef Rässler S: Statistical matching: A frequentist theory, practical applications, and alternative Bayesian approaches. 2002, New York: Springer-Verlag New York, IncCrossRef
23.
go back to reference Tunceli K, Bradley CJ, Nerenz D, Williams LK, Pladevall M, Lafata JE: The impact of diabetes on employment and work productivity. Diabetes Care. 2005, 28 (11): 2662-2667. 10.2337/diacare.28.11.2662.CrossRefPubMed Tunceli K, Bradley CJ, Nerenz D, Williams LK, Pladevall M, Lafata JE: The impact of diabetes on employment and work productivity. Diabetes Care. 2005, 28 (11): 2662-2667. 10.2337/diacare.28.11.2662.CrossRefPubMed
24.
go back to reference Economics A: The growing cost of obesity in 2008: three years on. 2008, Canberra: Diabetes Australia Economics A: The growing cost of obesity in 2008: three years on. 2008, Canberra: Diabetes Australia
25.
go back to reference World Health Organization: WHO guide to identifying the economic consequences of disease and injury. 2009, Geneva, Switzerland: World Health Organization Financing DoHS, Services HSa World Health Organization: WHO guide to identifying the economic consequences of disease and injury. 2009, Geneva, Switzerland: World Health Organization Financing DoHS, Services HSa
26.
go back to reference Van den Hout WB: The value of productivity: human-capital versus friction-cost method. Ann Rheum Dis. 2010, 69: i89-i91. 10.1136/ard.2009.117150.CrossRefPubMed Van den Hout WB: The value of productivity: human-capital versus friction-cost method. Ann Rheum Dis. 2010, 69: i89-i91. 10.1136/ard.2009.117150.CrossRefPubMed
27.
go back to reference Brouwer WB, Koopmanschap MA: The friction-cost method: replacement for nothing and leisure for free?. Pharmacoeconomics. 2005, 23: 105-111. 10.2165/00019053-200523020-00002.CrossRefPubMed Brouwer WB, Koopmanschap MA: The friction-cost method: replacement for nothing and leisure for free?. Pharmacoeconomics. 2005, 23: 105-111. 10.2165/00019053-200523020-00002.CrossRefPubMed
28.
go back to reference Layard R, Nickell S, Jackman R: Unemployment: Macroeconomic Performance and the Labour Market. 2005, Oxford: Oxford University PressCrossRef Layard R, Nickell S, Jackman R: Unemployment: Macroeconomic Performance and the Labour Market. 2005, Oxford: Oxford University PressCrossRef
29.
go back to reference Creighton A: It’s a hard dole life. 2012, Sydney: The Australian: The Australian, 29 August, 2012 Creighton A: It’s a hard dole life. 2012, Sydney: The Australian: The Australian, 29 August, 2012
31.
go back to reference Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, Khunti K, et al: Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Br Med J. 2007, 334 (7588): 299-10.1136/bmj.39063.689375.55.CrossRef Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, Khunti K, et al: Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Br Med J. 2007, 334 (7588): 299-10.1136/bmj.39063.689375.55.CrossRef
32.
go back to reference Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, Davies MJ, Khunti K: Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis. Br Med J. 2008, 336: 1180-1185. 10.1136/bmj.39545.585289.25.CrossRef Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, Davies MJ, Khunti K: Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis. Br Med J. 2008, 336: 1180-1185. 10.1136/bmj.39545.585289.25.CrossRef
33.
go back to reference Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. N Engl J Med. 2002, 346 (6): 393-403.CrossRefPubMedCentral Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. N Engl J Med. 2002, 346 (6): 393-403.CrossRefPubMedCentral
34.
go back to reference Passey ME, Shrestha RN, Bertram MY, Schofield DJ, Vos T, Callander EJ, Percival R, Kelly S: The impact of diabetes prevention on labour force participation and income of older Australians: an economic study. BMC Public Health. 2012, 12: 16-10.1186/1471-2458-12-16.CrossRefPubMedPubMedCentral Passey ME, Shrestha RN, Bertram MY, Schofield DJ, Vos T, Callander EJ, Percival R, Kelly S: The impact of diabetes prevention on labour force participation and income of older Australians: an economic study. BMC Public Health. 2012, 12: 16-10.1186/1471-2458-12-16.CrossRefPubMedPubMedCentral
35.
go back to reference Himmelstein DU, Warren E, Thorne D, Woolhandler S: Illness and injury as contributors to Bankruptcy. Health Affairs. 2005, 24 (1): Himmelstein DU, Warren E, Thorne D, Woolhandler S: Illness and injury as contributors to Bankruptcy. Health Affairs. 2005, 24 (1):
36.
go back to reference Australian Institute of Health and Welfare: Health expenditure Australia 2011–12. Health and welfare expenditure series no 50. 2013, Canberra: AIHW, Cat. no. HWE 59 Australian Institute of Health and Welfare: Health expenditure Australia 2011–12. Health and welfare expenditure series no 50. 2013, Canberra: AIHW, Cat. no. HWE 59
Metadata
Title
The economic impact of diabetes through lost labour force participation on individuals and government: evidence from a microsimulation model
Authors
Deborah Schofield
Michelle M Cunich
Rupendra N Shrestha
Megan E Passey
Lennert Veerman
Emily J Callander
Simon J Kelly
Robert Tanton
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-220

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