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Brouwer W, Verbooy K, Hoefman R, van Exel J. Production Losses due to Absenteeism and Presenteeism: The Influence of Compensation Mechanisms and Multiplier Effects. PHARMACOECONOMICS 2023; 41:1103-1115. [PMID: 36856941 PMCID: PMC9976676 DOI: 10.1007/s40273-023-01253-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Productivity costs can form a large and influential component of total costs in an economic evaluation taking a societal perspective. In calculating productivity costs, estimating productivity losses is a central element. Compensation mechanisms and multiplier effects may influence these losses but remain understudied. Compensation mechanisms could reduce productivity losses while multiplier effects may increase them. METHODS Data on productivity losses were collected in 2015 using an online survey among a sample of persons aged 15-65 years in The Netherlands who worked at least 12 h per week and reported to have experienced absenteeism and/or presenteeism during the past 4 weeks. A total of 877 respondents completed the survey that contained questions on productivity losses, compensation mechanisms, and multiplier effects. RESULTS We found that 45.5% of the respondents reported absenteeism (average 6.5 days) during the past 4 weeks, losing on average 48.7 working hours, while presenteeism was experienced by 75.9% of respondents, with an average loss of 10.7 working hours. Compensation mechanisms were reported by 76.9% of respondents, compensating almost 80% of their lost production, while multiplier effects were reported by 23.6% of respondents, reducing the productivity of 4.2 colleagues by 27.8% on average, implying a multiplier of 2.1 in that subgroup. CONCLUSIONS This study highlights that compensation mechanisms and multiplier effects are common and may substantially affect production losses. Investigating these mechanisms and effects further, as well as their interactions, remains important. Translating these findings into productivity cost calculations in economic evaluations is not straightforward and requires attention, especially since compensation mechanisms may not be costless and, for multiplier effects, the value of hours of colleagues may not be similar to that of the person experiencing health problems.
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Affiliation(s)
- Werner Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Kaya Verbooy
- Hotel Management School Maastricht, Maastricht, The Netherlands
| | - Renske Hoefman
- The Netherlands Institute for Social Research, The Hague, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Akksilp K, Isaranuwatchai W, Teerawattananon Y, Chen C. The association between health costs and physical inactivity; analysis from the Physical Activity at Work study in Thailand. Front Public Health 2023; 11:1037699. [PMID: 36960361 PMCID: PMC10027789 DOI: 10.3389/fpubh.2023.1037699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Physical inactivity increases the risks of several common yet serious non-communicable diseases, costing a tremendous amount of health expenditure globally. This study aimed to estimate the association between health costs and physical inactivity in Thailand. Methods Data from the Physical Activity at Work cluster randomized controlled trial participants with valid objective physical activity data were extracted. Health costs were collected using the Health and Welfare Survey and the Work Productivity and Activity Impairment Questionnaire and were categorized into past-month outpatient illness, past-year inpatient illness, and past-week presenteeism and absenteeism. Time spent in moderate-to-vigorous physical activity was used to determine the activity level according to the current guideline (i.e., ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity equivalent physical activity per week). The primary analysis evaluated the association between direct cost (treatment and travel costs) and societal cost (direct cost plus absenteeism due to the illness) of past-month outpatient illness and physical inactivity using a two-part model. Results In total, 277 participants with a mean age of 38.7 were included. Average direct and societal cost due to past-month outpatient illness were 146 THB (3.99 USD) (SD = 647 THB) and 457 THB (12.5 USD) (SD = 1390 THB), respectively. Compared to active participants, direct and societal cost of past-month outpatient illness were 153 THB (4.18 USD) (95%CI: -54.7 to 360 THB) and 426 THB (11.7 USD) (95%CI: 23.3 to 829 THB) higher in physically inactive individuals, respectively, adjusted for covariates. The additional societal cost of past-month outpatient illness was 145% higher in physically inactive participants compared to active participants. On the other hand, there was no significant association in direct and societal cost of past-year inpatient illness nor past-week indirect costs between physically active and non-active participants. Discussion Results were similar to recent findings in different countries. However, the findings should be generalized with caution due to the small sample size and potential bias from reverse causation. Future research is crucial for clarifying the health costs of physical inactivity in Thailand and other countries.
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Affiliation(s)
- Katika Akksilp
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Yot Teerawattananon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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Chapdelaine A, Vasiliadis HM, Provencher MD, Norton PJ, Roberge P. Cost-effectiveness of transdiagnostic group cognitive behavioural therapy for anxiety disorders v. treatment as usual: economic evaluation of a pragmatic randomized controlled trial over an 8-month time horizon using self-reported data. Psychol Med 2023; 53:1-13. [PMID: 36695038 DOI: 10.1017/s0033291722003920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND This economic evaluation supplements a pragmatic randomized controlled trial conducted in community care settings, which showed superior improvement in the symptoms of adults with anxiety disorders who received 12 sessions of transdiagnostic cognitive-behavioural group therapy in addition to treatment as usual (tCBT + TAU) compared to TAU alone. METHODS This study evaluates the cost-utility and cost-effectiveness of tCBT + TAU over an 8-month time horizon. For the reference case, quality-adjusted life years (QALYs) obtained using the EQ-5D-5L, and the health system perspective were chosen. Alternatively, anxiety-free days (AFDs), derived from the Beck Anxiety Inventory, and the limited societal perspective were considered. Unadjusted incremental cost-effectiveness/utility ratios were calculated. Net-benefit regressions were done for a willingness-to-pay (WTP) thresholds range to build cost-effectiveness acceptability curves (CEAC). Sensitivity analyses were included. RESULTS Compared to TAU (n = 114), tCBT + TAU (n = 117) generated additional QALYs, AFDs, and higher mental health care costs from the health system perspective. From the health system and the limited societal perspectives, at a WTP of Can$ 50 000/QALY, the CEACs showed that the probability of tCBT + TAU v. TAU being cost-effective was 97 and 89%. Promising cost-effectiveness results using AFDs are also presented. The participation of therapists from the public health sector could increase cost-effectiveness. CONCLUSIONS From the limited societal and health system perspectives, this first economic evaluation of tCBT shows favourable cost-effectiveness results at a WTP threshold of Can$ 50 000/QALY. Future research is needed to replicate findings in longer follow-up studies and different health system contexts to better inform decision-makers for a full-scale implementation.
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Affiliation(s)
- Alexandra Chapdelaine
- PRIMUS Research Group, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e avenue Nord, local Z7-3004, Sherbrooke, Québec, J1H 5N4, Canada
| | - Helen-Maria Vasiliadis
- Université de Sherbrooke - Campus de Longueuil, Charles-Le Moyne Research Center, 150 Place Charles Lemoyne, Longueuil, Québec, J4K 0A8, Canada
| | - Martin D Provencher
- École de psychologie, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Université Laval, Québec, Québec, G1V 0A6, Canada
| | - Peter J Norton
- The Cairnmillar Institute, 391-393 Tooronga Rd, Hawthorn East, Victoria 3123, Australia
| | - Pasquale Roberge
- Department of family medicine and emergency medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e avenue Nord, local Z7-3004, Sherbrooke, Québec, J1H 5N4, Canada
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Naylor NR, Evans S, Pouwels KB, Troughton R, Lamagni T, Muller-Pebody B, Knight GM, Atun R, Robotham JV. Quantifying the primary and secondary effects of antimicrobial resistance on surgery patients: Methods and data sources for empirical estimation in England. Front Public Health 2022; 10:803943. [PMID: 36033764 PMCID: PMC9413182 DOI: 10.3389/fpubh.2022.803943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/04/2022] [Indexed: 01/21/2023] Open
Abstract
Antimicrobial resistance (AMR) may negatively impact surgery patients through reducing the efficacy of treatment of surgical site infections, also known as the "primary effects" of AMR. Previous estimates of the burden of AMR have largely ignored the potential "secondary effects," such as changes in surgical care pathways due to AMR, such as different infection prevention procedures or reduced access to surgical procedures altogether, with literature providing limited quantifications of this potential burden. Former conceptual models and approaches for quantifying such impacts are available, though they are often high-level and difficult to utilize in practice. We therefore expand on this earlier work to incorporate heterogeneity in antimicrobial usage, AMR, and causative organisms, providing a detailed decision-tree-Markov-hybrid conceptual model to estimate the burden of AMR on surgery patients. We collate available data sources in England and describe how routinely collected data could be used to parameterise such a model, providing a useful repository of data systems for future health economic evaluations. The wealth of national-level data available for England provides a case study in describing how current surveillance and administrative data capture systems could be used in the estimation of transition probability and cost parameters. However, it is recommended that such data are utilized in combination with expert opinion (for scope and scenario definitions) to robustly estimate both the primary and secondary effects of AMR over time. Though we focus on England, this discussion is useful in other settings with established and/or developing infectious diseases surveillance systems that feed into AMR National Action Plans.
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Affiliation(s)
- Nichola R. Naylor
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, United Kingdom,Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, Antimicrobial Resistance (AMR) Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom,Healthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis division, United Kingdom Health Security Agency, London, United Kingdom,*Correspondence: Nichola R. Naylor
| | - Stephanie Evans
- Healthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis division, United Kingdom Health Security Agency, London, United Kingdom
| | - Koen B. Pouwels
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, United Kingdom,The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, United Kingdom
| | - Rachael Troughton
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, United Kingdom
| | - Theresa Lamagni
- Healthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis division, United Kingdom Health Security Agency, London, United Kingdom
| | - Berit Muller-Pebody
- Healthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis division, United Kingdom Health Security Agency, London, United Kingdom
| | - Gwenan M. Knight
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, Antimicrobial Resistance (AMR) Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rifat Atun
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Julie V. Robotham
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, United Kingdom,Healthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis division, United Kingdom Health Security Agency, London, United Kingdom
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Naylor NR, Evans S, Pouwels KB, Troughton R, Lamagni T, Muller-Pebody B, Knight GM, Atun R, Robotham JV. Quantifying the primary and secondary effects of antimicrobial resistance on surgery patients: Methods and data sources for empirical estimation in England. Front Public Health 2022. [DOI: 10.5210.3389/fpubh.2022.803943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Antimicrobial resistance (AMR) may negatively impact surgery patients through reducing the efficacy of treatment of surgical site infections, also known as the “primary effects” of AMR. Previous estimates of the burden of AMR have largely ignored the potential “secondary effects,” such as changes in surgical care pathways due to AMR, such as different infection prevention procedures or reduced access to surgical procedures altogether, with literature providing limited quantifications of this potential burden. Former conceptual models and approaches for quantifying such impacts are available, though they are often high-level and difficult to utilize in practice. We therefore expand on this earlier work to incorporate heterogeneity in antimicrobial usage, AMR, and causative organisms, providing a detailed decision-tree-Markov-hybrid conceptual model to estimate the burden of AMR on surgery patients. We collate available data sources in England and describe how routinely collected data could be used to parameterise such a model, providing a useful repository of data systems for future health economic evaluations. The wealth of national-level data available for England provides a case study in describing how current surveillance and administrative data capture systems could be used in the estimation of transition probability and cost parameters. However, it is recommended that such data are utilized in combination with expert opinion (for scope and scenario definitions) to robustly estimate both the primary and secondary effects of AMR over time. Though we focus on England, this discussion is useful in other settings with established and/or developing infectious diseases surveillance systems that feed into AMR National Action Plans.
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MacLeod KE, Ye Z, Donald B, Wang G. A Literature Review of Productivity Loss Associated with Hypertension in the United States. Popul Health Manag 2022; 25:297-308. [PMID: 35119298 PMCID: PMC9536345 DOI: 10.1089/pop.2021.0201] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A literature review of peer-reviewed articles published 2000-2019 was conducted to determine the types and extent of hypertension-associated productivity loss among adults in the United States. All monetary outcomes were standardized to 2019 $ by using the Employment Cost Index. Twenty-seven articles met the inclusion criteria. Nearly half of the articles (12 articles) presented monetary outcomes of productivity loss. Absenteeism (14 articles) and presenteeism (8 articles) were most frequently assessed. Annual absenteeism was estimated to cost more than $11 billion, nationally controlling for sociodemographic characteristics. The annual additional costs per person were estimated at $63 for short-term disability, $72-$330 for absenteeism, and $53-$156 for presenteeism, controlling for participant characteristics; and may be as high as $2362 for absenteeism and presenteeism when considered in combination. The annual additional time loss per person was estimated as 1.3 days for absenteeism, controlling for common hypertension comorbidities, including stroke and diabetes; and 15.6 days for work and home productivity loss combined, controlling for sociodemographic characteristics. The loss from absenteeism alone might be more than 20% of the total medical expenditure of hypertension. Although the differences in estimation methods and study populations make it challenging to synthesize the costs across the studies, this review provides detailed information on the various types of productivity loss. In addition, the ways in which methods could be standardized for future research are discussed. Accounting for the costs from productivity loss can help public health officials, health insurers, employers, and researchers better understand the economic burden of hypertension.
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Affiliation(s)
- Kara E. MacLeod
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
- ASRT, Inc., Atlanta, Georgia, USA
| | - Zhiqiu Ye
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
| | - Bruce Donald
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
- ASRT, Inc., Atlanta, Georgia, USA
| | - Guijing Wang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
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Ta-Thi KN, Chuang KJ. A Comparison of the Validities of Traditional Chinese Versions of the Work Productivity and Activity Impairment Questionnaire: General Health and the World Health Organization's Health and Work Performance Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074417. [PMID: 35410101 PMCID: PMC8998541 DOI: 10.3390/ijerph19074417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022]
Abstract
There is a lack of valid instruments for measuring productivity loss due to illness. This study aimed to compare the validities of traditional Chinese versions of the Work Productivity and Activity Impairment: General Health (C-WPAI:GH) and the World Health Organization's Health and Work Performance Questionnaire (C-WHO-HPQ), and to define the factors associated with productivity loss. We conducted a cross-sectional study of 165 Taiwanese employees in technology companies. Spearman's correlation coefficients and ANOVAs were used to test the validities of the C-WPAI:GH and C-WHO-HPQ. Bayesian model averaging was used for multiple linear regression to define the factors related to productivity loss. The C-WPAI:GH had acceptable validities for assessing the productivity loss of Taiwanese employees. The C-WHO-HPQ had acceptable content validity and concurrent criterion validity. However, the construct validity of the C-WHO-HPQ was insufficient (less than 75% of results were consistent with our hypotheses). Absenteeism in the C-WPAI:GH was associated with education, physical functioning and job satisfaction. There were significant associations of bodily pain, social functioning and general health with presenteeism, overall work impairment and activity impairment in the C-WPAI:GH. A linear correlation was found between education and activity impairment in the C-WPAI:GH. The C-WPAI:GH can be used to evaluate productivity loss due to illness.
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Affiliation(s)
- Kim-Ngan Ta-Thi
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan;
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan;
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-2-27361661
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Rodriguez Llorian E, Zhang W, Khakban A, Patten S, Traboulsee A, Oh J, Kolind S, Prat A, Tam R, Lynd LD. Productivity loss among people with early multiple sclerosis: A Canadian study. Mult Scler 2022; 28:1414-1423. [PMID: 35137613 PMCID: PMC9260491 DOI: 10.1177/13524585211069070] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To analyze work productivity loss and costs, including absenteeism (time missed from work), presenteeism (reduced productivity while working), and unpaid work loss, among a sample of employed people with multiple sclerosis (pwMS) in Canada, as well as its association with clinical, sociodemographic, and work-related factors. METHODS We used cross-sectional data collected as part of the Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo) and information from the Valuation of Lost Productivity questionnaire. RESULTS Among 512 pwMS who were employed, 97% showed no or mild disability and 55% experienced productivity loss due to MS in the prior 3 months. Total productivity time loss over a 3-month period averaged 60 hours (SD = 107; 23 from presenteeism, 19 from absenteeism, and 18 from unpaid work), leading to a mean cost of lost productivity of CAD$2480 (SD = 4282) per patient, with an hourly paid productivity loss greater than the wage loss. Fatigue retained significant associations with all productivity loss outcomes. CONCLUSION Unpaid work loss and productivity losses exceeding those of the employee alone (due to teamwork and associated factors) are key additional contributors of the high economic burden of MS. Workplace accommodations and treatments targeted at fatigue could lessen the economic impact of MS.
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Affiliation(s)
- Elisabet Rodriguez Llorian
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Wei Zhang
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada/Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, BC, Canada
| | - Amir Khakban
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Scott Patten
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Anthony Traboulsee
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Shannon Kolind
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Alexandre Prat
- Department of Neurology, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada
| | - Roger Tam
- Department of Radiology and School of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Larry D Lynd
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada/Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, BC, Canada
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Lambert-Obry V, Lafrance JP, Savoie M, Lachaine J. The Impact of Hypoglycemia on Productivity Loss and Utility in Type 2 Diabetes Patients Treated with Insulin in Real-World Canadian Practice: Protocol for a Prospective Study (Preprint). JMIR Res Protoc 2021; 11:e35461. [PMID: 35343912 PMCID: PMC9002599 DOI: 10.2196/35461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) imposes a substantial burden owing to its increasing prevalence and life-threatening complications. In patients who do not achieve glycemic targets with oral antidiabetic drugs, the initiation of insulin is recommended. However, a serious concern regarding insulin is drug-induced hypoglycemia. Hypoglycemia is known to affect quality of life and the use of health care resources. However, health economics and outcomes research (HEOR) data for economic modelling are limited, particularly regarding utility values and productivity losses. Objective This real-world prospective study aims to assess the impact of hypoglycemia on productivity and utility in insulin-treated adults with T2DM from Ontario and Quebec, Canada. Methods This noninterventional, multicenter, 3-month prospective study will recruit patients from 4 medical clinics and 2 endocrinology or diabetes clinics. Patients will be identified using appointment lists and enrolled through consecutive sampling during routinely scheduled consultations. To be eligible, patients must be aged ≥18 years, diagnosed with T2DM, and treated with insulin. Utility and productivity will be measured using the EQ-5D-5L questionnaire and Institute for Medical Technology Assessment Productivity Cost Questionnaire, respectively. Questionnaires will be completed 4, 8, and 12 weeks after recruitment. Generalized estimating equation models will be used to investigate productivity losses and utility decrements associated with incident hypoglycemic events while controlling for individual patient characteristics. A total of 500 patients will be enrolled to ensure the precision of HEOR estimates. Results This study is designed to fill a gap in the Canadian evidence on the impact of hypoglycemia on HEOR outcomes. More specifically, it will generate productivity and utility inputs for the economic modeling of T2DM. Conclusions Insulin therapy is expensive, and hypoglycemia is a significant component of economic evaluation. Robust HEOR data may help health technology assessment agencies in future reimbursement decision-making. International Registered Report Identifier (IRRID) PRR1-10.2196/35461
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Affiliation(s)
| | | | - Michelle Savoie
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | - Jean Lachaine
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
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Hubens K, Krol M, Coast J, Drummond MF, Brouwer WBF, Uyl-de Groot CA, Hakkaart-van Roijen L. Measurement Instruments of Productivity Loss of Paid and Unpaid Work: A Systematic Review and Assessment of Suitability for Health Economic Evaluations From a Societal Perspective. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1686-1699. [PMID: 34711370 DOI: 10.1016/j.jval.2021.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 05/16/2023]
Abstract
OBJECTIVES This study aimed (1) to perform a systematic literature review of instruments for measuring productivity loss of paid and unpaid work and (2) to assess the suitability (in terms of identification, measurement, and valuation) of these instruments for use in health economic evaluations from a societal perspective. METHODS Articles published from 2018 were sourced from PubMed/Medline, PsycInfo, Embase, and Econlit. Using 2 separate search strategies, eligible economic evaluations and validation studies were selected and unique measurement instruments identified. A data-extraction form was developed by studying previous literature and consulting an international panel of experts in the field of productivity costs. This data-extraction form was applied to assess the suitability of instruments for use in economic evaluations. RESULTS A total of 5982 articles were retrieved from the databases, of which 99 economic evaluations and 9 validation studies were included in the review. A total of 42 unique measurement instruments were identified. Nine instruments provided quantified measures of absenteeism, presenteeism, and unpaid work. Five instruments supplied the necessary information to enable the use of at least 1 common valuation method. The Health and Labour Questionnaire-Short Form, Health and Labour Questionnaire, and Institute for Medical Technology Assessment Productivity Cost Questionnaire met both criteria. Nevertheless, the developers replaced the Health and Labour Questionnaire-Short Form and Health and Labour Questionnaire by the more recently developed Institute for Medical Technology Assessment Productivity Cost Questionnaire. CONCLUSIONS Although many instruments for measuring productivity loss were identified, most were not suitable for capturing productivity changes for economic evaluations from a societal perspective. Future research can benefit from this study by making an informed instrument choice for the measurement of productivity loss of paid and unpaid work.
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Affiliation(s)
- Kimberley Hubens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands.
| | | | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK
| | | | - Werner B F Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands; Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Munk Killingmo R, Tveter AT, Småstuen MC, Storheim K, Grotle M. Comparison of self-reported and public registered absenteeism among people on long-term sick leave due to musculoskeletal disorders: criterion validity of the iMTA Productivity Cost Questionnaire. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:865-872. [PMID: 34061299 PMCID: PMC8275498 DOI: 10.1007/s10198-021-01294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate criterion validity of the iMTA Productivity Cost Questionnaire (iPCQ) by comparing iPCQ-reported occurrence and duration of long-term absenteeism (> 4 weeks) with public registry data collected from the Norwegian Labour and Welfare Administration (NAV) among people on sick leave due to musculoskeletal disorders. METHOD Baseline data from a cohort study was used, in which people on sick leave for at least 4 weeks due to musculoskeletal disorders were recruited electronically through the NAV website. To compare the occurrence of long-term absenteeism overall agreement between the two methods was measured by percentages. To compare the duration (number of days with absenteeism) and adjusted duration (number of days with complete absenteeism) of long-term absenteeism we conducted intraclass correlation coefficient (ICC) two-way random average agreement, descriptive statistic and Wilcoxon signed-rank test. RESULTS In total, 144 participants with a median age (range) of 49 (24-67) were included. The overall agreement on the occurrence of long-term absenteeism was 100%. The ICC value was 0.97 and 0.86 for duration and adjusted duration of long-term absenteeism, respectively. The median difference(iPCQ-registry) between the two methods was 0 and 17 days for long-term absenteeism duration and adjusted duration, respectively. A significant difference between the two methods was observed (Wilcoxon signed-rank test, p < 0.001) with regards to adjusted duration of long-term absenteeism. CONCLUSION The iPCQ showed good agreement with public registry data regarding the occurrence and duration of long-term absenteeism among people with musculoskeletal disorders on long-term sick-leave in Norway. However, the iPCQ does not cover part-time sick-leave and thereby potentially overestimate the total amount of long-term absenteeism. TRIAL REGISTRATION ClinicalTrials.gov Identifier no. NCT04196634.
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Affiliation(s)
| | - Anne Therese Tveter
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway
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12
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Al-Aqeel SA, AlAujan SS, Almazrou SH. The Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) and the Medical Consumption Questionnaire (iMCQ): Translation and Cognitive Debriefing of the Arabic Version. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147232. [PMID: 34299684 PMCID: PMC8303958 DOI: 10.3390/ijerph18147232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/28/2022]
Abstract
The aim of this study was to translate the Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) and the Medical Consumption Questionnaire (iMCQ) from English into Arabic and perform cognitive debriefing in a Saudi Arabian setting. We conducted the translation according to guidelines, including two independent forward translations and a backward translation. Cognitive debriefing was carried out in two stages. First, the pre-final translated versions of the two questionnaires were tested on a group of respondents (n = 5) using face-to-face or telephone interviews. The participants completed a copy of the questionnaires, identified items or questions that were confusing or misunderstood, and then answered a series of open-ended questions about their understanding of each instruction, question and response option. Second, another group of participants (n = 17) completed the questionnaire and circled any word that was confusing or difficult to understand and provided comments on the questionnaires. The Arabic translation and linguistic validation were realized without any major difficulties. The few changes made after cognitive debriefing generally related to changing one word to a more appropriate Arabic word. The final Arabic translation needs to be validated for psychometric properties such as validity and reliability before being recommended for use in future research.
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13
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Himmler S, Branner JC, Ostwald DA. The societal impact of a biologic treatment of ankylosing spondylitis: a case study based on secukinumab. J Comp Eff Res 2020; 10:143-155. [PMID: 33252266 DOI: 10.2217/cer-2020-0077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: This study estimates the societal benefits of using biologics like secukinumab (SEC) instead of nonsteroidal anti-inflammatory drugs for treating patients with ankylosing spondylitis in Germany. Materials & methods: A Markov and a population model were used to predict the functional impairment of German ankylosing spondylitis patients using SEC or nonsteroidal anti-inflammatory drugs. This was translated into avoided productivity losses, which were valued according to gross value added. Results: The productivity impairment of SEC users was predicted to decrease by 20 percentage points, corresponding to 12.8 and 32.7 million hours in paid and unpaid work and a monetary value of €1.6 billion from 2016 to 2030. Accounting for economic spillover effects increases the societal value to € 3.3 billion. Conclusion: The improvements in functional impairment due to biologics could lead to sizable productivity effects.
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Affiliation(s)
| | | | - Dennis A Ostwald
- WifOR Institute, Darmstadt 64283, Germany.,School of International Business & Entrepreneurship (SIBE) Steinbeis University, Herrenberg 71083, Germany
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14
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Homrich PHP, Dantas-Filho FF, Martins LL, Marcon ER. Presenteeism among health care workers: literature review. Rev Bras Med Trab 2020; 18:97-102. [PMID: 32783010 DOI: 10.5327/z1679443520200478] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/18/2019] [Indexed: 11/05/2022] Open
Abstract
Presenteeism is an occupational and psychosocial phenomenon with negative impact on the work environment. In addition to causing losses in productivity losses, it also has implications for the state of health of workers. Therefore, presenteeism is likely to become a serious public health problem. The aim of the present study was to discuss the implications, means for evaluation and impact of presenteeism on the health and work of health care workers. We performed a literature search in database PubMed using keywords presenteeism, absenteeism, nurse presenteeism, physician presenteeism, sickness presenteeism, physician health organization, and working sick. We conclude that adequate assessment, raising the health managers' awareness about the risks and harms associated with this phenomenon, and developing management tools will contribute to reduce the impact of presenteeism. This seems to be the proper path to make this problem more visible and hinder its growth.
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Affiliation(s)
- Paulo Henrique Poti Homrich
- Department of Anesthesia and Perioperative Medicine, Clinical Hospital - Porto Alegre (RS), Brazil. Department of Anesthesia and Perioperative Medicine Clinical Hospital Brazil
| | - Fabio Fernandes Dantas-Filho
- Department of Occupational Health, Clinical Hospital - Porto Alegre (RS), Brazil. Department of Occupational Health Clinical Hospital Brazil
| | - Laura Luna Martins
- Move Research Group, Clinical Hospital - Porto Alegre, (RS), Brazil. Move Research Group Clinical Hospital Brazil
| | - Emilian Rejane Marcon
- Department of Bariatric Surgery/Saint Cecilia Health Basic Unit, Clinical Hospital - Porto Alegre (RS), Brazil. Department of Bariatric Surgery Saint Cecilia Health Basic Unit Clinical Hospital Brazil
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15
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Cultural Adaptation and Validation of the Korean Version of the iMTA Productivity Cost Questionnaire. Healthcare (Basel) 2020; 8:healthcare8020184. [PMID: 32599752 PMCID: PMC7349846 DOI: 10.3390/healthcare8020184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 01/09/2023] Open
Abstract
This study develops the Korean version of the Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) through translation/cultural adaptation and evaluation of psychometric properties. We included 110 outpatients visiting a gynecology clinic. We conducted the translation and cross-cultural adaptation of the iPCQ, including forward and back-translation, pilot test with cognitive debriefing, and finalization. We analyzed the feasibility (using average time of filling in the iPCQ and the proportion of missing values), test–retest reliability (using the intra-class correlation coefficient [ICC]), and validity (concurrent validity with the Work Productivity and Activity Impairment [WPAI] and construct validity with the 36-Item Short Form Survey [SF-36], using Spearman’s ρ). The Korean version of iPCQ showed appropriate feasibility (average filling in time was 5.0 min without missing values), and had excellent values in the domains of absenteeism, presenteeism, and unpaid work for test–retest reliability (ICC: 0.92–0.99). For concurrent validity, the Korean version of iPCQ showed moderate–high correlation for absenteeism and presenteeism with the WPAI. All domains of productivity losses measured by the Korean version of iPCQ showed negative correlation with the quality of life estimated by the SF-36. Through this study, we developed a Korean instrument that can measure and value health-related productivity losses including unpaid work as well as absenteeism and presenteeism.
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16
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Munk R, Storheim K, Småstuen MC, Grotle M. Measuring Productivity Costs in Patients With Musculoskeletal Disorders: Measurement Properties of the Institute for Medical Technology Assessment Productivity Cost Questionnaire. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1410-1416. [PMID: 31806198 DOI: 10.1016/j.jval.2019.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/21/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) was recently developed to cover all domains of productivity costs; absenteeism, presenteeism and productivity costs related to unpaid work. The original iPCQ has not been tested with respect to neither content or construct validity, nor reliability, and there is no Norwegian version of the questionnaire. OBJECTIVES To translate and cross-culturally adapt the iPCQ into Norwegian and to test its measurement properties among patients with musculoskeletal disorders. METHODS Translation and cross-cultural adaptation was conducted according to guidelines, and measurement properties were investigated using a cross-sectional design including a test-retest assessment. Patients with musculoskeletal disorders were recruited from secondary care. Data quality, content validity (10 patients evaluated comprehensibility, 2 researchers and 1 clinician evaluated relevance and comprehensiveness), construct validity (factor analysis, internal consistency, divergent hypothesis testing), and test-retest reliability (intraclass correlation coefficient two-way random average agreement, Cohen's unweighted kappa) were assessed. RESULTS In total, 115 patients with a mean age (SD) of 46 (9) years were included, and 62 responded to the retest. The questionnaire was feasible, with little missing data and no floor or ceiling effects. Content validity displayed good comprehensibility and relevance and sufficient comprehensiveness. Factor analysis revealed a 3-component solution accounting for 82% of the total variance; items loaded as expected and supported the original structure of the iPCQ. Internal consistency was acceptable for the 3 components of productivity cost, with an inter-item correlation ranging from 0.42 to 0.62. Further, a total of 91% of our hypotheses were verified. The intraclass correlation coefficient values ranged from 0.88 to 0.99 for all items except one; kappa ranged from 0.61 to 0.92, indicating overall good reliability of the questionnaire. CONCLUSIONS The Norwegian iPCQ showed good measurement properties among patients with musculoskeletal disorders from secondary care in Norway. We therefore recommend the iPCQ as a useful tool for measuring productivity costs in patients with musculoskeletal disorders.
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Affiliation(s)
- Rikke Munk
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
| | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
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17
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Himmler S, Mueller M, Sherif B, Ostwald D. A case study applying a novel approach to estimate the social impact of a medical innovation - the use of secukinumab for psoriatic arthritis in Germany. Expert Rev Pharmacoecon Outcomes Res 2019; 20:369-378. [DOI: 10.1080/14737167.2019.1644169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Bintu Sherif
- Biostatistics, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Dennis Ostwald
- Health Economics, WifOR GmbH, Darmstadt, Germany
- School of International Business and Entrepreneurship (SIBE), Steinbeis University Berlin, Berlin, Germany
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18
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Beemster TT, van Velzen JM, van Bennekom CAM, Reneman MF, Frings-Dresen MHW. Test-Retest Reliability, Agreement and Responsiveness of Productivity Loss (iPCQ-VR) and Healthcare Utilization (TiCP-VR) Questionnaires for Sick Workers with Chronic Musculoskeletal Pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:91-103. [PMID: 29549605 DOI: 10.1007/s10926-018-9767-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this study was to assess test-retest reliability, agreement, and responsiveness of questionnaires on productivity loss (iPCQ-VR) and healthcare utilization (TiCP-VR) for sick-listed workers with chronic musculoskeletal pain who were referred to vocational rehabilitation. Methods Test-retest reliability and agreement was assessed with a 2-week interval. Responsiveness was assessed at discharge after a 15-week vocational rehabilitation (VR) program. Data was obtained from six Dutch VR centers. Test-retest reliability was determined with intraclass correlation coefficient (ICC) and Cohen's kappa. Agreement was determined by Standard Error of Measurement (SEM), smallest detectable changes (on group and individual level), and percentage observed, positive and negative agreement. Responsiveness was determined with area under the curve (AUC) obtained from receiver operation characteristic (ROC). Results A sample of 52 participants on test-retest reliability and agreement, and a sample of 223 on responsiveness were included in the analysis. Productivity loss (iPCQ-VR): ICCs ranged from 0.52 to 0.90, kappa ranged from 0.42 to 0.96, and AUC ranged from 0.55 to 0.86. Healthcare utilization (TiCP-VR): ICC was 0.81, and kappa values of the single healthcare utilization items ranged from 0.11 to 1.00. Conclusions The iPCQ-VR showed good measurement properties on working status, number of hours working per week and long-term sick leave, and low measurement properties on short-term sick leave and presenteeism. The TiCP-VR showed adequate reliability on all healthcare utilization items together and medication use, but showed low measurement properties on the single healthcare utilization items.
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Affiliation(s)
- Timo T Beemster
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.
- Academic Medical Center, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Judith M van Velzen
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
- Academic Medical Center, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Coen A M van Bennekom
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
- Academic Medical Center, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Monique H W Frings-Dresen
- Academic Medical Center, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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19
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Mori K, Mori T, Nagata T, Nagata M, Iwasaki M, Sakai H, Kimura K, Shinzato N. Factors of occurrence and improvement methods of presenteeism attributed to diabetes: A systematic review. J Occup Health 2019; 61:36-53. [PMID: 30698334 PMCID: PMC6499359 DOI: 10.1002/1348-9585.12034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/11/2018] [Indexed: 01/22/2023] Open
Abstract
Objective A systematic review was performed to study factors of occurrence and improvement methods of presenteeism attributed to diabetes. Methods We set 2 clinical questions; (a) how comorbidities and complications of diabetes induce presenteeism and (b) what interventions or conditions effectively improve presenteeism. Then, we conducted a comprehensive search with MEDLINE/PubMed and Scopus databases and extracted those that met the clinical questions. Results Eighteen papers studied occurrence of presenteeism by comorbidities and complications of diabetes. Most studies were cross‐sectional and had a low quality of evidence. However, the associations of hypoglycemia, diabetic neuropathy, and mood disorders with presenteeism were relatively well studied. The papers that discussed effective interventions or conditions for improving presenteeism were very limited. Conclusions Our review suggests that presenteeism attributed to diabetes is mainly caused by hypoglycemia, diabetic neuropathy, and mood disorders. There are very limited evidences, but available information suggests that improving glycemic control, adjusting treatment regimen by evaluating the impact on work, providing psychological support, and developing suitable work accommodations may effectively reduce presenteeism.
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Affiliation(s)
- Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takahiro Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masako Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mahoko Iwasaki
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroki Sakai
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koki Kimura
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Natsumi Shinzato
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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20
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Abma F, Bjorner JB, Amick BC, Bültmann U. Two valid and reliable work role functioning questionnaire short versions were developed: WRFQ 5 and WRFQ 10. J Clin Epidemiol 2019; 105:101-111. [DOI: 10.1016/j.jclinepi.2018.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/30/2018] [Accepted: 09/18/2018] [Indexed: 11/28/2022]
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21
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Verbooy K, Hoefman R, van Exel J, Brouwer W. Time Is Money: Investigating the Value of Leisure Time and Unpaid Work. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1428-1436. [PMID: 30502787 DOI: 10.1016/j.jval.2018.04.1828] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/14/2018] [Accepted: 04/19/2018] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Lost unpaid work and leisure time of patients due to ill health often are not included in economic evaluations, even in those taking a societal perspective. This study investigated the monetary value of unpaid work and leisure time to enable the inclusion of patient time in economic evaluations. METHODS A contingent valuation study was performed to derive monetary values of unpaid work and leisure time. Data were collected with an online survey among a representative sample of people 18 years and older in the Netherlands in terms of age, sex, and educational level in January 2014 (n = 316). Willingness-to-accept (WTA) and willingness-to-pay (WTP) values were analyzed with a two-part model. First, a logistic regression model investigated the willingness to trade in the WTA/WTP tasks. Second, a log-transformed ordinary least squares regression model analyzed the level of positive WTA and WTP values. RESULTS The average WTA value for unpaid work was €15.83, and the average WTA value for leisure time was €15.86. The mean WTP value for leisure time was €9.37 when traded against unpaid work, and €9.56 when traded against paid work. Differences in monetary values of unpaid work and leisure time were partly explained by respondents' income, educational level, age, and household composition. CONCLUSIONS Researchers can adhere to the societal perspective by also including the value of hours of lost unpaid work and leisure time in economic evaluations. As a first indication of its value, we suggest applying the WTA value of €16.
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Affiliation(s)
- Kaya Verbooy
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Renske Hoefman
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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22
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Tuffaha H, El-Saifi N, Chambers S, Scuffham P. New challenges in psycho-oncology: Economic evaluation of psychosocial services in cancer: Challenges and best practice recommendations. Psychooncology 2018; 28:3-10. [PMID: 30440112 DOI: 10.1002/pon.4933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Haitham Tuffaha
- Griffith University Menzies Health Institute Queensland, Nathan, Queensland, Australia.,Griffith University Centre for Applied Health Economics, Nathan, Queensland, Australia
| | - Najwan El-Saifi
- Griffith University Menzies Health Institute Queensland, Nathan, Queensland, Australia.,Griffith University Centre for Applied Health Economics, Nathan, Queensland, Australia
| | - Suzanne Chambers
- Griffith University Menzies Health Institute Queensland, Nathan, Queensland, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Paul Scuffham
- Griffith University Menzies Health Institute Queensland, Nathan, Queensland, Australia.,Griffith University Centre for Applied Health Economics, Nathan, Queensland, Australia
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Wang EQ, Castrillón Velásquez MA, Murrell DF. The effects of autoimmune blistering diseases on work productivity: A review. Int J Womens Dermatol 2018; 4:131-138. [PMID: 30175214 PMCID: PMC6116828 DOI: 10.1016/j.ijwd.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 11/17/2022] Open
Abstract
This review examines the work productivity in patients with autoimmune blistering diseases (AIBDs). Work productivity and employment are important aspects of a patient's life, which can be affected by diseases. The Work Productivity and Activity Impairment Questionnaire (WPAIQ) is a validated instrument that can measure work productivity and assess the impact of disease on patients' work lives. There is currently a paucity of research that investigates the reason why AIBDs cause such a large impact on work productivity and whether AIBDs affect employment status. Using quality of life (QoL) instruments in conjunction with the creation of an adapted WPAIQ to examine the reasons behind work impairment may further characterize these effects and unveil a deeper understanding of stigmatization in the workplace as a factor of loss of work productivity.
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Affiliation(s)
- Esther Q. Wang
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- Premier Specialists Research and Development
- Faculty of Medicine, University of New South Wales and Australia, Sydney, New South Wales, Australia
| | - M. Adriana Castrillón Velásquez
- Premier Specialists Research and Development
- Faculty of Medicine, University of New South Wales and Australia, Sydney, New South Wales, Australia
- Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Dedee F. Murrell
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- Premier Specialists Research and Development
- Faculty of Medicine, University of New South Wales and Australia, Sydney, New South Wales, Australia
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24
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Lohela-Karlsson M, Nybergh L, Jensen I. Perceived health and work-environment related problems and associated subjective production loss in an academic population. BMC Public Health 2018; 18:257. [PMID: 29444651 PMCID: PMC5813431 DOI: 10.1186/s12889-018-5154-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 02/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background The aim was to investigate the prevalence of health problems and work environment problems and how these are associated with subjective production loss among women and men at an academic workplace. An additional aim was to investigate whether there were differences between women and men according to age group, years at current workplace, academic rank or managerial position. Methods A questionnaire was sent in 2011 to all employees at a Swedish university (n = 5144). Only researchers and teachers were included in the study (n = 3207). Spearman correlations were performed to investigate differences in health and work environment problems. Employees who reported having experienced work environment or health problems in the previous seven days (n = 1475) were included in the analyses in order to investigate differences in subjective production loss. This was done using Student’s t-test, One-way Anova and generalized linear models. Results The response rate was 63% (n = 2022). A total of 819 academic staff (40% of the population) reported experiencing either health problems, work environment problems or both during the previous seven days. The prevalence of health problems only or a combination of work environment and health problems was higher among women than men (p-value ˂0.05). This was especially the case for younger women, those in lower academic positions and those who had worked for fewer years at their current workplace. No difference was found for work environment problems. The majority of the employees who reported problems said that these problems affected their ability to perform at work (84–99%). The average production loss varied between 31 and 42% depending on the type of problem. Production loss due to health-related and work-environment related problems was highest among junior researchers and managers. No significant difference between men and women was found in the level of production loss. Conclusion Subjective production loss in academia can be associated with health and work- environment problems. These losses appear similar for women and men even though younger female academics, women in lower academic ranks and those with fewer years of employment in their current workplace report a higher prevalence of health problems and combined work-environment and health problems than men.
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Affiliation(s)
- Malin Lohela-Karlsson
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, SE, Sweden.
| | - Lotta Nybergh
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, SE, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77, Stockholm, SE, Sweden
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Mayer S, Paulus ATG, Łaszewska A, Simon J, Drost RMWA, Ruwaard D, Evers SMAA. Health-Related Resource-Use Measurement Instruments for Intersectoral Costs and Benefits in the Education and Criminal Justice Sectors. PHARMACOECONOMICS 2017; 35:895-908. [PMID: 28597368 PMCID: PMC5563348 DOI: 10.1007/s40273-017-0522-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Intersectoral costs and benefits (ICBs), i.e. costs and benefits of healthcare interventions outside the healthcare sector, can be a crucial component in economic evaluations from the societal perspective. Pivotal to their estimation is the existence of sound resource-use measurement (RUM) instruments; however, RUM instruments for ICBs in the education or criminal justice sectors have not yet been systematically collated or their psychometric quality assessed. This review aims to fill this gap. METHODS To identify relevant instruments, the Database of Instruments for Resource Use Measurement (DIRUM) was searched. Additionally, a systematic literature review was conducted in seven electronic databases to detect instruments containing ICB items used in economic evaluations. Finally, studies evaluating the psychometric quality of these instruments were searched. RESULTS Twenty-six unique instruments were included. Most frequently, ICB items measured school absenteeism, tutoring, classroom assistance or contacts with legal representatives, police custody/prison detainment and court appearances, with the highest number of items listed in the Client Service Receipt Inventory/Client Sociodemographic and Service Receipt Inventory/Client Service Receipt Inventory-Children's Version (CSRI/CSSRI/CSRI-C), Studying the Scope of Parental Expenditures (SCOPE) and Self-Harm Intervention, Family Therapy (SHIFT) instruments. ICBs in the education sector were especially relevant for age-related developmental disorders and chronic diseases, while criminal justice resource use seems more important in mental health, including alcohol-related disorders or substance abuse. Evidence on the validity or reliability of ICB items was published for two instruments only. CONCLUSION With a heterogeneous variety of ICBs found to be relevant for several disease areas but many ICB instruments applied in one study only (21/26 instruments), setting-up an international task force to, for example, develop an internationally adaptable instrument is recommended.
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Affiliation(s)
- Susanne Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Aggie T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Ruben M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Matsuzaki J, Suzuki H, Togawa K, Yamane T, Mori H, Komori T, Masaoka T, Kanai T. Burden of impaired sleep quality on work productivity in functional dyspepsia. United European Gastroenterol J 2017; 6:398-406. [PMID: 29774153 DOI: 10.1177/2050640617726466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/24/2017] [Indexed: 12/17/2022] Open
Abstract
Background Impaired sleep quality is common, and can reduce work productivity in patients with functional dyspepsia (FD). Objective The objective of this article is to evaluate whether there is a direct association between the presence of FD and the severity of impaired sleep quality, and to calculate the economic loss due to the decreased work productivity associated with sleep quality. Methods In Study 1, using a web-based survey completed by workers with and without FD, we evaluated impaired sleep quality, work and daily productivity, and the severity of reflux and bowel symptoms. In Study 2, the association between the presence of FD and the severity of impaired sleep quality was validated in a hospital-based cohort. Results In both Study 1 and 2, although impaired sleep quality was more frequent in participants with FD than in those without FD, the independent association between the presence of FD and the severity of impaired sleep quality was not observed after adjustment for the severity of reflux and bowel symptoms. FD participants with impaired sleep quality reported additional economic loss of 53,500 Japanese yen/month. Conclusion Although the association between impaired sleep quality and FD was indirect, concomitant impaired sleep quality could worsen economic loss.
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Affiliation(s)
- Juntaro Matsuzaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo, Japan
| | - Hidekazu Suzuki
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Koji Togawa
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Tsuyoshi Yamane
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Mori
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Komori
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuhiro Masaoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Work Productivity Loss in Young Workers Is Substantial and Is Associated With Spinal Pain and Mental Ill-health Conditions. J Occup Environ Med 2017; 59:237-245. [PMID: 28267094 DOI: 10.1097/jom.0000000000000990] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the effect of spinal pain and mental ill-health conditions on work productivity in 22-year-old workers. METHODS A cross-sectional design using data from the Raine Study cohort (n = 867) including self-reported work productivity and self-report of health practitioner diagnosed medical conditions. RESULT Mean (median, 25th-percentile, 75th-percentile) annualized cost of health-related absenteeism was $AUD1899 ($0, $0, $1738) per worker. Annualized cost of presenteeism was $AUD10,674 ($6573, $4003, $13,087) per worker. Spinal pain and mental ill-health conditions were associated with increased health-related absenteeism, but not presenteeism. CONCLUSION Work productivity loss in young workers is a substantial problem needing priority attention. Addressing spinal pain and mental ill-health may improve productivity of this important sector of the workforce.
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Bouma SE, Postema SG, Bongers RM, Dijkstra PU, van der Sluis CK. Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study. Disabil Rehabil 2017. [DOI: 10.1080/09638288.2017.1289418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sjoukje E. Bouma
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Sietke G. Postema
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Raoul M. Bongers
- University of Groningen, University Medical Center Groningen, Center of Human Movement Sciences, Groningen, the Netherlands
| | - Pieter U. Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, the Netherlands
| | - Corry K. van der Sluis
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
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Health-Related Quality of Life Impairment and Indirect Cost of Crohn's Disease: A Self-Report Study in Poland. PLoS One 2016; 11:e0168586. [PMID: 27992531 PMCID: PMC5161376 DOI: 10.1371/journal.pone.0168586] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 12/02/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS Evidence on indirect cost of Crohn's disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity). METHODS A self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients' characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient's version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients' productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients' productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders. RESULTS The responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (p<0.001) and lower indirect costs by 71% (p = 0.003) for absenteeism, 41% (p = 0.030) for presenteeism, 76% (p<0.001) for productivity loss at unpaid work, and 75% (p<0.001) for informal care. CONCLUSIONS Our study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland.
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Shearer J, McCrone P, Romeo R. Economic Evaluation of Mental Health Interventions: A Guide to Costing Approaches. PHARMACOECONOMICS 2016; 34:651-64. [PMID: 26922076 DOI: 10.1007/s40273-016-0390-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Costing approaches in the economic evaluation of mental health interventions are complicated by the broad societal impacts of mental health, and the multidisciplinary nature of mental health interventions. This paper aims to provide a practical guide to costing approaches across a wide range of care inputs and illness consequences relevant to the treatment of mental health. The resources needed to deliver mental health interventions are highly variable and depend on treatment settings (institutional, community), treatment providers (medical, non-medical) and formats (individual, group, electronic). Establishing the most appropriate perspective is crucial when assessing the costs associated with a particular mental health problem or when evaluating interventions to treat them. We identify five key cost categories (social care, informal care, production losses, crime and education) impacted by mental health and discuss contemporary issues in resource use measurement and valuation, including data sources and resource use instruments.
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Affiliation(s)
- James Shearer
- King's Health Economics, King's College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Paul McCrone
- King's Health Economics, King's College London, London, UK.
- Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Renee Romeo
- King's Health Economics, King's College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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31
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Krol M, Papenburg J, Tan SS, Brouwer W, Hakkaart L. A noticeable difference? Productivity costs related to paid and unpaid work in economic evaluations on expensive drugs. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2016; 17:391-402. [PMID: 25876834 PMCID: PMC4837201 DOI: 10.1007/s10198-015-0685-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/18/2015] [Indexed: 05/06/2023]
Abstract
Productivity costs can strongly impact cost-effectiveness outcomes. This study investigated the impact in the context of expensive hospital drugs. This study aimed to: (1) investigate the effect of productivity costs on cost-effectiveness outcomes, (2) determine whether economic evaluations of expensive drugs commonly include productivity costs related to paid and unpaid work, and (3) explore potential reasons for excluding productivity costs from the economic evaluation. We conducted a systematic literature review to identify economic evaluations of 33 expensive drugs. We analysed whether evaluations included productivity costs and whether inclusion or exclusion was related to the study population's age, health and national health economic guidelines. The impact on cost-effectiveness outcomes was assessed in studies that included productivity costs. Of 249 identified economic evaluations of expensive drugs, 22 (9 %) included productivity costs related to paid work. One study included unpaid productivity. Mostly, productivity cost exclusion could not be explained by the study population's age and health status, but national guidelines appeared influential. Productivity costs proved often highly influential. This study indicates that productivity costs in economic evaluations of expensive hospital drugs are commonly and inconsistently ignored in economic evaluations. This warrants caution in interpreting and comparing the results of these evaluations.
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Affiliation(s)
- Marieke Krol
- Department of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000, Rotterdam, The Netherlands.
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands.
| | | | - Siok Swan Tan
- Department of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000, Rotterdam, The Netherlands
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Werner Brouwer
- Department of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000, Rotterdam, The Netherlands
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Leona Hakkaart
- Department of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000, Rotterdam, The Netherlands
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
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Aboagye E, Jensen I, Bergström G, Hagberg J, Axén I, Lohela-Karlsson M. Validity and test-retest reliability of an at-work production loss instrument. Occup Med (Lond) 2016; 66:377-82. [PMID: 26933065 DOI: 10.1093/occmed/kqw021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Besides causing ill health, a poor work environment may contribute to production loss. Production loss assessment instruments emphasize health-related consequences but there is no instrument to measure reduced work performance related to the work environment. AIMS To examine convergent validity and test-retest reliability of health-related production loss (HRPL) and work environment-related production loss (WRPL) against a valid comparable instrument, the Health and Work Performance Questionnaire (HPQ). METHODS Cross-sectional study of employees, not on sick leave, who were asked to self-rate their work performance and production losses. Using the Pearson correlation and Bland and Altman's Test of Agreement, convergent validity was examined. Subgroup analyses were performed for employees recording problem-specific reduced work performance. Consistency of pairs of HRPL and WRPL for samples responding to both assessments was expressed using Intraclass Correlation Coefficient (ICC) and tests of repeatability. RESULTS A total of 88 employees participated and 44 responded to both assessments. Test of agreement between measurements estimates a mean difference of 0.34 for HRPL and -0.03 for WRPL compared with work performance. This indicates that the production loss questions are valid and moderately associated with work performance for the total sample and subgroups. ICC for paired HRPL assessments was 0.90 and 0.91 for WRPL, i.e. the test-retest reliability was good and suggests stability in the instrument. CONCLUSIONS HRPL and WRPL can be used to measure production loss due to health-related and work environment-related problems. These results may have implications for advancing methods of assessing production loss, which represents an important cost to employers.
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Affiliation(s)
- E Aboagye
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - I Jensen
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - G Bergström
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - J Hagberg
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - I Axén
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - M Lohela-Karlsson
- Department of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Postema SG, Bongers RM, Brouwers MA, Burger H, Norling-Hermansson LM, Reneman MF, Dijkstra PU, van der Sluis CK. Upper Limb Absence: Predictors of Work Participation and Work Productivity. Arch Phys Med Rehabil 2016; 97:892-9. [PMID: 26792618 DOI: 10.1016/j.apmr.2015.12.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/17/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). DESIGN Cross-sectional study: postal survey (response rate, 45%). SETTING Twelve rehabilitation centers and orthopedic workshops. PARTICIPANTS Individuals (n=207) with unilateral transverse upper limb reduction deficiency (RD) or acquired amputation (AA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of control subjects (n=90) matched on age and sex. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Employment status, self-reported work productivity measured with the Quality-Quantity method, and self-reported upper extremity work demands measured with the Upper Extremity Work Demands scale. RESULTS Seventy-four percent of the individuals with RD and 57% of the individuals with AA were employed (vs 82% of the control group and 66% of the general population). Male sex, younger age, a medium or higher level of education, prosthesis use, and good general health were predictors of work participation. Work productivity was similar to that of the control group. Higher work productivity was inversely related to musculoskeletal complaint-related pain. When having predominantly mentally demanding work, individuals with ULA perceived higher upper extremity work demands compared with controls. CONCLUSIONS Work participation of individuals with RD was slightly higher compared with that of the general population, whereas employment rates of individuals with AA were slightly lower. Furthermore, work productivity did not differ between individuals with RD, AA, and controls.
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Affiliation(s)
- Sietke G Postema
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Raoul M Bongers
- Center of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michael A Brouwers
- Rehabilitation Center De Hoogstraat Revalidatie, Utrecht, The Netherlands
| | - Helena Burger
- University Rehabiltiation Institute and University of Ljubljama Medical Faculty, Ljubljana, Slovenia
| | - Liselotte M Norling-Hermansson
- Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Region Örebro County, Örebro, Sweden
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, The Netherlands
| | - Corry K van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Gilworth G, Smyth MG, Smith J, Tennant A. The Manual Work Instability Scale: development and validation. Occup Med (Lond) 2016; 66:300-4. [PMID: 26747888 DOI: 10.1093/occmed/kqv217] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increasing awareness of the burden of absenteeism and reduced performance at work highlights the importance of early identification of individuals experiencing work instability (WI), a mismatch between functional and cognitive abilities and job demands. AIMS To develop and validate a screening questionnaire to measure WI in manual workers. METHODS Questionnaire items were generated via qualitative interviews with manual workers and a draft survey instrument was completed by workers in a variety of fields. Rasch analysis was used interactively to assess the psychometric aspects of the emerging scale, including unidimensionality and absence of item bias (differential item functioning). RESULTS A total of 17 qualitative interviews generated 110 potential items for the questionnaire. The item set resolved to a 25-item scale, which satisfied model expectations (item residual mean = -0.13, SD = 1.04; person residual mean = -0.29, SD = 0.75), had good reliability (alpha = 0.86) and strict unidimensionality (t-test 7.5% confidence interval 3.8-11.2). CONCLUSIONS The Manual Work Instability Scale is a short psychometrically robust questionnaire based on the concept of WI, which incorporates both musculoskeletal symptoms and relevant psychosocial factors. It may prove effective in screening and identifying WI in workers in predominantly physical occupations.
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Affiliation(s)
- G Gilworth
- Department of Rehabilitation Medicine, Faculty of Medicine and Health, The University of Leeds, D Floor, Martin Wing, The General Infirmary at Leeds, Gt. George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - M G Smyth
- Work Fit Occupational Physiotherapy and Ergonomics Services Ltd., 38 Newlay Lane, Leeds, West Yorkshire LS18 4LE, UK
| | - J Smith
- Work Fit Occupational Physiotherapy and Ergonomics Services Ltd., 38 Newlay Lane, Leeds, West Yorkshire LS18 4LE, UK
| | - A Tennant
- Schweizer Paraplegiker-Forschung AG, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland.
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Lohela Karlsson M, Busch H, Aboagye E, Jensen I. Validation of a measure of health-related production loss: construct validity and responsiveness - a cohort study. BMC Public Health 2015; 15:1148. [PMID: 26584735 PMCID: PMC4653835 DOI: 10.1186/s12889-015-2449-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 10/25/2015] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study is to evaluate the construct validity and responsiveness of a Swedish measure of health-related production loss as well as to investigate if there is a difference in the level of production loss within a population suffering from persistent back/neck pain and CMDs. Methods The sample was drawn from a study that assessed employees’ health and working capacity in 74 health care units before and after intervention. The study included 692 patients who reported working the previous six months at baseline measurement, and who were also asked to answer questions related to health-related production loss. Health-related measures were general health derived from Short Form-12, health-related quality of life derived from EQ-5D, and work ability derived from the Work Ability Index (WAI). Convergent validity and external responsiveness were assessed using Spearman’s Rank Correlation Coefficient and a linear regression model, respectively. Results The different measures of health showed a moderate-to-strong correlation with the measure of health-related production loss and fulfilled the criteria for construct validity. Changes in health and work ability led to significant changes in health-related production loss, which demonstrates external responsiveness. This result is valid for both the total population and for the two different subgroups that were evaluated. Conclusions The present study shows that this measure of health-related production loss is a valid measure for capturing production loss due to illness, and that work ability is more strongly correlated with health-related production loss than people’s general health is. The result shows an average of about 50 % reduced production due to illness, with back pain being the most costly.
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Affiliation(s)
- Malin Lohela Karlsson
- Unit of Intervention and Implementation Research (IIR), Institute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77, Stockholm, Sweden.
| | - Hillevi Busch
- Unit of Intervention and Implementation Research (IIR), Institute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Emmanuel Aboagye
- Unit of Intervention and Implementation Research (IIR), Institute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research (IIR), Institute of Environmental Medicine (IMM), Karolinska Institutet, SE 171 77, Stockholm, Sweden
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Unpaid work in health economic evaluations. Soc Sci Med 2015; 144:127-37. [DOI: 10.1016/j.socscimed.2015.09.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 08/20/2015] [Accepted: 09/06/2015] [Indexed: 01/01/2023]
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Ramsey SD, Willke RJ, Glick H, Reed SD, Augustovski F, Jonsson B, Briggs A, Sullivan SD. Cost-effectiveness analysis alongside clinical trials II-An ISPOR Good Research Practices Task Force report. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2015; 18:161-72. [PMID: 25773551 DOI: 10.1016/j.jval.2015.02.001] [Citation(s) in RCA: 501] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Clinical trials evaluating medicines, medical devices, and procedures now commonly assess the economic value of these interventions. The growing number of prospective clinical/economic trials reflects both widespread interest in economic information for new technologies and the regulatory and reimbursement requirements of many countries that now consider evidence of economic value along with clinical efficacy. As decision makers increasingly demand evidence of economic value for health care interventions, conducting high-quality economic analyses alongside clinical studies is desirable because they broaden the scope of information available on a particular intervention, and can efficiently provide timely information with high internal and, when designed and analyzed properly, reasonable external validity. In 2005, ISPOR published the Good Research Practices for Cost-Effectiveness Analysis Alongside Clinical Trials: The ISPOR RCT-CEA Task Force report. ISPOR initiated an update of the report in 2014 to include the methodological developments over the last 9 years. This report provides updated recommendations reflecting advances in several areas related to trial design, selecting data elements, database design and management, analysis, and reporting of results. Task force members note that trials should be designed to evaluate effectiveness (rather than efficacy) when possible, should include clinical outcome measures, and should obtain health resource use and health state utilities directly from study subjects. Collection of economic data should be fully integrated into the study. An incremental analysis should be conducted with an intention-to-treat approach, complemented by relevant subgroup analyses. Uncertainty should be characterized. Articles should adhere to established standards for reporting results of cost-effectiveness analyses. Economic studies alongside trials are complementary to other evaluations (e.g., modeling studies) as information for decision makers who consider evidence of economic value along with clinical efficacy when making resource allocation decisions.
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Affiliation(s)
- Scott D Ramsey
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Schools of Medicine and Pharmacy, University of Washington, Seattle, WA, USA.
| | - Richard J Willke
- Outcomes & Evidence Lead, CV/Metabolic, Pain, Urology, Gender Health, Global Health & Value, Pfizer, Inc., New York, NY, USA
| | - Henry Glick
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shelby D Reed
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Federico Augustovski
- Institute for Clinical Effectiveness and Health Policy (IECS), University of Buenos Aires, Buenos Aires, Argentina
| | - Bengt Jonsson
- Department of Economics, Stockholm School of Economics, Stockholm, Sweden
| | - Andrew Briggs
- William R. Lindsay Chair of Health Economics, University of Glasgow, Glasgow, Scotland, UK
| | - Sean D Sullivan
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Schools of Medicine and Pharmacy, University of Washington, Seattle, WA, USA
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