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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024; 47:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom; School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Hansen KS, Moreno-Ternero JD, Østerdal LP. Quality- and productivity-adjusted life years: From QALYs to PALYs and beyond. JOURNAL OF HEALTH ECONOMICS 2024; 95:102885. [PMID: 38705048 DOI: 10.1016/j.jhealeco.2024.102885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
We develop a unified framework for the measurement and valuation of health and productivity. Within this framework, we characterize evaluation functions allowing for compromises between the classical quality-adjusted life years (QALYs) and its polar productivity-adjusted life years (PALYs). Our framework and characterization results provide a new normative basis for the economic evaluation of health care interventions, as well as occupational health and safety policies, aimed to impact both health and productivity of individuals.
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Affiliation(s)
- Kristian S Hansen
- National Research Centre for the Working Environment (NFA), Copenhagen, Denmark.
| | | | - Lars P Østerdal
- Department of Economics, Copenhagen Business School, Denmark.
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3
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Bloom JE, Nehme E, Paratz ED, Dawson L, Nelson AJ, Ball J, Eliakundu A, Voskoboinik A, Anderson D, Bernard S, Burrell A, Udy AA, Pilcher D, Cox S, Chan W, Mihalopoulos C, Kaye D, Nehme Z, Stub D. Healthcare and economic cost burden of emergency medical services treated non-traumatic shock using a population-based cohort in Victoria, Australia. BMJ Open 2024; 14:e078435. [PMID: 38684259 PMCID: PMC11057314 DOI: 10.1136/bmjopen-2023-078435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES We aimed to assess the healthcare costs and impact on the economy at large arising from emergency medical services (EMS) treated non-traumatic shock. DESIGN We conducted a population-based cohort study, where EMS-treated patients were individually linked to hospital-wide and state-wide administrative datasets. Direct healthcare costs (Australian dollars, AUD) were estimated for each element of care using a casemix funding method. The impact on productivity was assessed using a Markov state-transition model with a 3-year horizon. SETTING Patients older than 18 years of age with shock not related to trauma who received care by EMS (1 January 2015-30 June 2019) in Victoria, Australia were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome assessed was the total healthcare expenditure. Secondary outcomes included healthcare expenditure stratified by shock aetiology, years of life lived (YLL), productivity-adjusted life-years (PALYs) and productivity losses. RESULTS A total of 21 334 patients (mean age 65.9 (±19.1) years, and 9641 (45.2%) females were treated by EMS with non-traumatic shock with an average healthcare-related cost of $A11 031 per episode of care and total cost of $A280 million. Annual costs remained stable throughout the study period, but average costs per episode of care increased (Ptrend=0.05). Among patients who survived to hospital, the average cost per episode of care was stratified by aetiology with cardiogenic shock costing $A24 382, $A21 254 for septic shock, $A19 915 for hypovolaemic shock and $A28 057 for obstructive shock. Modelling demonstrated that over a 3-year horizon the cohort lost 24 355 YLLs and 5059 PALYs. Lost human capital due to premature mortality led to productivity-related losses of $A374 million. When extrapolated to the entire Australian population, productivity losses approached $A1.5 billion ($A326 million annually). CONCLUSION The direct healthcare costs and indirect loss of productivity among patients with non-traumatic shock are high. Targeted public health measures that seek to reduce the incidence of shock and improve systems of care are needed to reduce the financial burden of this syndrome.
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Affiliation(s)
- Jason E Bloom
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - Emily Nehme
- Research & Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
| | | | - Luke Dawson
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Adam J Nelson
- Victorian Heart Institute, Clayton, North Carolina, Australia
| | - Jocasta Ball
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Amminadab Eliakundu
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Aleksandr Voskoboinik
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - David Anderson
- Ambulance Victoria, Doncaster, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | | | | | - Andrew A Udy
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | | | - Shelley Cox
- Research & Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
| | - William Chan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
- Western Health, St Albans, Victoria, Australia
| | | | - David Kaye
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - Ziad Nehme
- Research & Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
| | - Dion Stub
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
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Wen B, Ademi Z, Wu Y, Xu R, Yu P, Ye T, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Ambient PM 2.5 and productivity-adjusted life years lost in Brazil: a national population-based study. JOURNAL OF HAZARDOUS MATERIALS 2024; 467:133676. [PMID: 38354440 DOI: 10.1016/j.jhazmat.2024.133676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Enormous health burden has been associated with air pollution and its effects continue to grow. However, the impact of air pollution on labour productivity at the population level is still unknown. This study assessed the association between premature death due to PM2.5 exposure and the loss of productivity-adjusted life years (PALYs), in Brazil. We applied a novel variant of the difference-in-difference (DID) approach to assess the association. Daily all-cause mortality data in Brazil were collected from 2000-2019. The PALYs lost increased by 5.11% (95% CI: 4.10-6.13%), for every 10 µg/m3 increase in the 2-day moving average of PM2.5. A total of 9,219,995 (95% CI: 7,491,634-10,921,141) PALYs lost and US$ 268.05 (95% CI: 217.82-317.50) billion economic costs were attributed to PM2.5 exposure, corresponding to 7.37% (95% CI: 5.99-8.73%) of the total PALYs lost due to premature death. This study also found that 5,005,306 PALYs could be avoided if the World Health Organization (WHO) air quality guideline (AQG) level was met. In conclusion, this study demonstrates that ambient PM2.5 exposure is associated with a considerable labour productivity burden relating to premature death in Brazil, while over half of the burden could be prevented if the WHO AQG was met. The findings highlight the need to reduce ambient PM2.5 levels and provide strong evidence for the development of strategies to mitigate the economic impacts of air pollution.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia; School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia; School of Pharmacy, Faculty of Health Sciences, Kuopio Campus, University of Eastern Finland, FI-70211 Kuopio, Finland
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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5
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Hellebo A, Kengne AP, Ademi Z, Alaba O. The Burden of Type 2 Diabetes on the Productivity and Economy in Sub-Saharan Africa: A Life Table Modelling Analysis from a South African Perspective. PHARMACOECONOMICS 2024; 42:463-473. [PMID: 38267807 DOI: 10.1007/s40273-024-01353-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND AIM The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa (SSA). T2D increases the risk of premature death and reduces quality of life and work productivity. This population life table modelling analysis evaluated the impact of T2D in terms of productivity-adjusted life years (PALYs) on the South African working-age population. RESEARCH DESIGN AND METHODS Life table modelling was employed to simulate the follow-up of individuals aged 20-65 with T2D in South Africa (SA). Two life table models were developed to simulate health outcomes for a SA cohort with and without diabetes. The difference in the number of deaths, years of life lost (YLL), and PALYs lost between the two cohorts represented the burden of diabetes. Scenarios were simulated in which the proportions of gross domestic productivity (GDP), productivity indices, labour force dropout, and mortality risk trends were adjusted to lower and upper uncertainty bounds. Data were sourced from the International Diabetes Federation, Statistics SA, and both publicly available and published sources. We utilised the World Health Organization (WHO) standard annual discount rate of 3% for YLL and PALYs. RESULTS In 2019, an estimated 9.5% (7.68% men and 11.37% women) or 3.2 million total working-age people had T2D in SA. Simulated follow-up until retirement predicted 669,427 excess mortality, a loss of 6.2 million years of life (9.3%) and 13 million PALYs (30.6%) in SA. On average, this resulted in 3.1 PALYs lost per person. Based on the GDP per full-time employee in 2019, the PALYs loss equated to US$223 billion, or US$69,875 per person. CONCLUSIONS This study emphasises the significant impact of T2D on society and the economy. Relatively modest T2D prevention and treatment management enhancement could lead to substantial economic benefits in SA.
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Affiliation(s)
- Assegid Hellebo
- Health Economics Unit, School of Public Health, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa.
| | - Andre P Kengne
- Department of Medicine, University of Cape Town and Non-Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Olufunke Alaba
- Health Economics Unit, School of Public Health, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa
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6
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Ackerman IN, Buchbinder R, March L. Global Burden of Disease Study 2019: an opportunity to understand the growing prevalence and impact of hip, knee, hand and other osteoarthritis in Australia. Intern Med J 2023; 53:1875-1882. [PMID: 36114616 PMCID: PMC10946783 DOI: 10.1111/imj.15933] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/08/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Understanding population-level trends in osteoarthritis (OA) is critical for planning health services and disease prevention initiatives. AIM To examine trends in the burden of hip, knee, hand and other OA related conditions in Australia from 1990 to 2019 and consider the OA burden in the context of other common conditions associated with older age. METHODS Global Burden of Disease Study 2019 data for Australia on OA prevalence, OA-related years lived with disability (YLDs) and OA-related YLDs attributable to high body mass index (BMI) were sourced for 1990-2019. Age-standardised YLD data for ischaemic heart disease, stroke, dementia, type 2 diabetes and chronic obstructive pulmonary disease were obtained for comparison. RESULTS Overall, 3.20 million Australians were estimated to have OA in 2019, with substantial growth in the prevalence of hip (+171%), knee (+126%), hand (+110%) and other types of OA (+130%) from 1990 to 2019. Age-standardised prevalence rates reflect the contribution of population ageing. Concomitant growth in OA-related YLDs was also evident; knee OA and hand OA demonstrated the highest disease burden in 2019 (59 684 and 41 893 YLDs respectively). The proportion of knee OA burden attributable to high BMI was 36% in 2019. In 2019, age-standardised YLD rates were higher for OA (313 per 100 000 population) than other common conditions (range: 47 per 100 000 (ischaemic heart disease) to 284 per 100 000 (type 2 diabetes)). CONCLUSIONS OA is an increasingly prevalent, impactful condition with a high non-fatal disease burden relative to other health conditions. Growth in OA populations and OA-related disability underscore the need for enhanced investment in prevention and management.
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Affiliation(s)
- Ilana N. Ackerman
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Monash‐Cabrini Department of Musculoskeletal Health and Clinical EpidemiologyCabrini HealthMelbourneVictoriaAustralia
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Monash‐Cabrini Department of Musculoskeletal Health and Clinical EpidemiologyCabrini HealthMelbourneVictoriaAustralia
| | - Lyn March
- Faculty of Medicine and HealthInstitute of Bone and Joint Research, Kolling Institute, University of SydneySydneyNew South WalesAustralia
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Masenga SK, Povia JP, Lwiindi PC, Kirabo A. Recent Advances in Microbiota-Associated Metabolites in Heart Failure. Biomedicines 2023; 11:2313. [PMID: 37626809 PMCID: PMC10452327 DOI: 10.3390/biomedicines11082313] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023] Open
Abstract
Heart failure is a risk factor for adverse events such as sudden cardiac arrest, liver and kidney failure and death. The gut microbiota and its metabolites are directly linked to the pathogenesis of heart failure. As emerging studies have increased in the literature on the role of specific gut microbiota metabolites in heart failure development, this review highlights and summarizes the current evidence and underlying mechanisms associated with the pathogenesis of heart failure. We found that gut microbiota-derived metabolites such as short chain fatty acids, bile acids, branched-chain amino acids, tryptophan and indole derivatives as well as trimethylamine-derived metabolite, trimethylamine N-oxide, play critical roles in promoting heart failure through various mechanisms. Mainly, they modulate complex signaling pathways such as nuclear factor kappa-light-chain-enhancer of activated B cells, Bcl-2 interacting protein 3, NLR Family Pyrin Domain Containing inflammasome, and Protein kinase RNA-like endoplasmic reticulum kinase. We have also highlighted the beneficial role of other gut metabolites in heart failure and other cardiovascular and metabolic diseases.
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Affiliation(s)
- Sepiso K. Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-6602, USA
| | - Joreen P. Povia
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
| | - Propheria C. Lwiindi
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-6602, USA
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Glick DR, Abariga SA, Thomas I, Shipper AG, Gunia BC, Grandner MA, Rosenberg E, Hines SE, Capaldi V, Collen J, Wickwire EM. Economic Impact of Insufficient and Disturbed Sleep in the Workplace. PHARMACOECONOMICS 2023; 41:771-785. [PMID: 36933184 DOI: 10.1007/s40273-023-01249-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Insufficient and disturbed sleep are associated with significant morbidity among working-age adults. Poor sleep results in negative health outcomes and increases economic costs to employers. The current systematic review surveyed the peer-reviewed scientific literature and aggregated scientific evidence of sleep-related economic burdens borne by employers. METHODS A systematic review was performed to identify peer-reviewed, English language studies evaluating the economic impact of insufficient and disturbed sleep among adult employee populations. An exhaustive literature search was performed using keywords related to sleep, economics, and the workplace. Included were scientific studies (randomized controlled trials, cohort and case control studies, cross-sectional and longitudinal studies) examining specific employee populations with relevant sleep and economic outcomes. Each included study was evaluated for risk of bias and relevant data was extracted and summarized. RESULTS Sleep problems among employee populations are associated with worsened workplace outcomes, such as presenteeism, absenteeism, and accidents. Sleep problems also increased costs to employers, ranging from US$322 to US$1967 per employee. Interventions to improve sleep, such as the use of blue-light filtering glasses, strategic shift scheduling, and targeted interventions to treat insomnia, may improve workplace outcomes and reduce costs. CONCLUSIONS This review synthesizes the existing data regarding the negative impacts of insufficient and disturbed sleep on the workplace, suggesting that employers have an economic stake in their employees' sleep. TRIAL REGISTRATION PROSPERO: CRD42021224212.
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Affiliation(s)
- Danielle R Glick
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sleep Disorders Center, University of Maryland School of Medicine, 100 N Greene St, 2nd Floor, Baltimore, MD, 21201, USA.
| | - Samuel A Abariga
- Department of Epidemiology & Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Irine Thomas
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrea G Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
- Charles Library, Temple University, Philadelphia, PA, USA
| | - Brian C Gunia
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | | | - Stella E Hines
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Vincent Capaldi
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jacob Collen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Emerson M Wickwire
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sleep Disorders Center, University of Maryland School of Medicine, 100 N Greene St, 2nd Floor, Baltimore, MD, 21201, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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9
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Lee P, Xia T, Zomer E, van Vreden C, Pritchard E, Newnam S, Collie A, Iles R, Ademi Z. Exploring the Health and Economic Burden Among Truck Drivers in Australia: A Health Economic Modelling Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:389-398. [PMID: 36357754 PMCID: PMC9648998 DOI: 10.1007/s10926-022-10081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 05/12/2023]
Abstract
Background The transport and logistics industry contributes to a significant proportion of the Australian economy. However, few studies have explored the economic and clinical burden attributed to poor truck driver health. We therefore estimated the work-related mortality burden among truck drivers over a 10-year period. Methods Dynamic life table modelling was used to simulate the follow-up of the Australian male working-age population (aged 15-65 years) over a 10-year period of follow-up (2021-2030). The model estimated the number of deaths occurring among the Australian working population, as well as deaths occurring for male truck drivers. Data from the Driving Health study and other published sources were used to inform work-related mortality and associated productivity loss, hospitalisations and medication costs, patient utilities and the value of statistical life year (VoSLY). All outcomes were discounted by 5% per annum. Results Over 10 years, poor truck driver health was associated with a loss of 21,173 years of life lived (discounted), or 18,294 QALYs (discounted). Healthcare costs amounted to AU$485 million (discounted) over this period. From a broader, societal perspective, a total cost of AU$2.6 billion (discounted) in lost productivity and AU$4.7 billion in lost years of life was estimated over a 10-year period. Scenario analyses supported the robustness of our findings. Conclusions The health and economic consequences of poor driver health are significant, and highlight the need for interventions to reduce the burden of work-related injury or disease for truck drivers and other transport workers.
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Affiliation(s)
- Peter Lee
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- School of Health and Social Development, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia.
| | - Ting Xia
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Caryn van Vreden
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Elizabeth Pritchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sharon Newnam
- Monash University Accident Research Centre, Melbourne, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ross Iles
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
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10
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Wen B, Ademi Z, Wu Y, Xu R, Yu P, Ye T, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Productivity-adjusted life years lost due to non-optimum temperatures in Brazil: A nationwide time-series study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 873:162368. [PMID: 36828065 DOI: 10.1016/j.scitotenv.2023.162368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Non-optimal temperatures are associated with premature deaths globally. However, the evidence is limited in low- and middle-income countries, and the productivity losses due to non-optimal temperatures have not been quantified. We aimed to estimate the work-related impacts and economic losses attributable to non-optimal temperatures in Brazil. We collected daily mortality data from 510 immediate regions in Brazil during 2000 and 2019. A two-stage time-series analysis was applied to evaluate the association between non-optimum temperatures and the Productivity-Adjusted Life-Years (PALYs) lost. The temperature-PALYs association was fitted for each location in the first stage and then we applied meta-analyses to obtain the national estimations. The attributable fraction (AF) of PALY lost due to ambient temperatures and the corresponding economic costs were calculated for different subgroups of the working-age population. A total of 3,629,661 of PALYs lost were attributed to non-optimal temperatures during 2000-2019 in Brazil, corresponding to 2.90 % (95 % CI: 1.82 %, 3.95 %) of the total PALYs lost. Non-optimal temperatures have led to US$104.86 billion (95 % CI: 65.95, 142.70) of economic costs related to PALYs lost and the economic burden was more substantial in males and the population aged 15-44 years. Higher risks of extreme cold temperatures were observed in the South region in Brazil while extreme hot temperatures were observed in the Central West and Northeast regions. In conclusion, non-optimal temperatures are associated with considerable labour losses as well as economic costs in Brazil. Tailored policies and adaptation strategies should be proposed to mitigate the impacts of non-optimal temperatures on the labour supply in a changing climate.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, 3052, Australia
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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11
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Marquina C, Makarounas-Kirchmann K, Holden K, Sasse A, Ademi Z. The preventable productivity burden of sleep apnea in Australia: a lifetime modelling study. J Sleep Res 2023; 32:e13748. [PMID: 36303525 DOI: 10.1111/jsr.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
Obstructive sleep apnea (OSA) is a common disorder. OSA is associated with cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM) and depression, among other comorbidities. We aim to determine the productivity burden of OSA in Australia using productivity-adjusted life-years (PALYs). Using life table modelling, we built a multistate Markov model to estimate the impact of moderate to severe OSA on the whole working-age Australian population in 2021 (aged 20-65 years) with OSA until retirement (aged 66 years). The model also captured the impact of OSA on CVD, T2DM, depression, and vehicle-related accidents. Data for OSA and comorbidities and Australian specific labour data, were extracted from published sources. A second cohort was then modelled to test the effect of a hypothetical intervention, assuming a 10% reduction in OSA prevalence and a 10% reduction in comorbidities in patients with OSA. The primary outcome of interest were PALYs accrued. All outcomes were discounted 5% annually. Over a lifetime, the Australian population with OSA accrued 193,713,441 years of life lived and 182,737,644 PALYs. A reduction of 10% in OSA prevalence and comorbidities would result in 45,401 extra years of life lived and 150,950 extra PALYs. This resulted in more than AU$25 billion of gained gross domestic product over the lifetime of the working population. Our study highlights the substantial burden of OSA on the Australian population and the need to tailor interventions at the population level to reduce the health and economic impacts.
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Affiliation(s)
- Clara Marquina
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kelly Makarounas-Kirchmann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Snoretox Ltd., Melbourne, Victoria, Australia
| | - Karen Holden
- Snoretox Ltd., Melbourne, Victoria, Australia.,School of Health Sciences, Bundoora West Campus, RMIT University, Melbourne, Victoria, Australia
| | - Anthony Sasse
- Snoretox Ltd., Melbourne, Victoria, Australia.,School of Health Sciences, Bundoora West Campus, RMIT University, Melbourne, Victoria, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
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12
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Jin X, Ackerman IN, Ademi Z. Loss of Productivity-Adjusted Life-Years in Working-Age Australians Due to Knee Osteoarthritis: A Life-Table Modeling Approach. Arthritis Care Res (Hoboken) 2023; 75:482-490. [PMID: 35348305 DOI: 10.1002/acr.24886] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/19/2022] [Accepted: 03/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Productivity-adjusted life-years (PALYs) offers a novel approach for quantifying the productivity burden of chronic conditions at the population level over the working lifespan. This study was undertaken to estimate the productivity burden of knee osteoarthritis (KOA) among working-age Australians, defined as lost PALYs and lost gross domestic product (GDP). METHODS A static life-table model was constructed to simulate the experiences of working Australians (between the ages of 15-64 years) with KOA and those without KOA, with follow-up to 65 years (retirement age), a 1-year cycle length, and an annual discount rate of 5%. KOA prevalence data were obtained from the 2019 Global Burden of Diseases, Injuries, and Risk Factors study. Demographic and mortality data were sourced from the Australian Bureau of Statistics. Health utilities and productivity indices were derived from published sources. Population-level losses in years of life, quality-adjusted life-years (QALYs), and PALYs attributable to KOA were estimated by comparing estimates in the KOA cohort to the no KOA cohort. RESULTS In 2019, a total of 913,539 working-age Australians were estimated to have KOA, with an overall prevalence of 5.5% (4.5% in men and 6.5% in women). By retirement age, KOA was associated with 39,602 excess deaths, 125,651 years of life lost, 1,938,059 QALYs lost, and 1,943,287 PALYs lost. The economic impact of lost productivity due to KOA amounted to 424 billion Australian dollars in lost GDP. CONCLUSION Our modeling demonstrates a significant economic burden of KOA among the working Australian population, with marked productivity loss. Our findings highlight the need for public health funding and scalable population-level strategies for effective KOA prevention and support to maintain productive working.
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Affiliation(s)
- Xingzhong Jin
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia, and Sydney Musculoskeletal Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ilana N Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine and Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia
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Hartmanis SL, Baker EK, Godler DE, Liew D. Estimating the impact of Angelman syndrome on parental productivity in Australia using productivity-adjusted life years. Disabil Health J 2022; 16:101423. [PMID: 36639256 DOI: 10.1016/j.dhjo.2022.101423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Angelman syndrome (AS) is a rare genetic condition characterized by global developmental delay, including severe intellectual disability. The parents of persons with AS experience increased stress, anxiety, and depression. This impacts parents' career choices and productivity. OBJECTIVE To estimate, for the first time, the total productivity lost by the parents of persons with AS over a 10-year period in Australia and the corresponding cost to society. METHODS A cost-of-illness model with simulated follow-up over a 10-year period was developed, with 2019 as the baseline year, facilitated by a Markov chain of life tables. The prevalence of persons with AS and their parents, the productivity-adjusted life years (PALYs) lost by parents, and the cost to society were estimated. Key data were obtained from a prospective cohort of AS families, peer-reviewed literature, and publicly available sources. RESULTS The base-case productivity burden borne by the estimated 330 living parents of the 428 prevalent persons with AS totaled AUD$45.30 million, corresponding to a loss of 38.42% of PALYs per parent. CONCLUSIONS Caring for a child with AS has a significant impact on the productivity of affected parents, with a large associated impact on the broader Australian economy.
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Affiliation(s)
- Sally L Hartmanis
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Emma K Baker
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, Victoria, 3010, Australia; School of Psychology and Public Health, La Trobe University, Plenty Road and Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - David E Godler
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
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14
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Morton JI, Lazzarini PA, Polkinghorne KR, Carstensen B, Magliano DJ, Shaw JE. The association of attained age, age at diagnosis, and duration of type 2 diabetes with the long-term risk for major diabetes-related complications. Diabetes Res Clin Pract 2022; 190:110022. [PMID: 35905888 DOI: 10.1016/j.diabres.2022.110022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/18/2022] [Accepted: 07/24/2022] [Indexed: 11/03/2022]
Abstract
AIM We evaluated the associations of age and duration of type 2 diabetes with major diabetes-related complications. METHODS We included 1.1 million people with type 2 diabetes from the Australian diabetes registry, followed from 2010 to 2019. We estimated the incidence of hospitalization or death from myocardial infarction (MI), stroke, and heart failure (HF), and hospitalisation for lower extremity amputation (LEA); end-stage kidney disease (ESKD; kidney replacement therapy or death from ESKD); and all-cause mortality. Poisson regression was used to model incidence by attained age, age at diabetes diagnosis, and duration of diabetes. RESULTS Risk for complications increased exponentially with diabetes duration. Effects of attained age differed for each complication: age was a strong risk factor for MI, stroke, HF, and mortality, while diabetes duration, not age, was the predominant determinant of LEA and ESKD. At a given age, a 10-year longer diabetes duration was associated with a 1.1-1.5-fold increased risk of stroke and mortality, a 1.5-2.0-fold increased risk of MI and HF, and a 2-4-fold increased risk of LEA and ESKD. CONCLUSIONS Duration of diabetes is a stronger risk factor for ESKD and LEA than it is for cardiovascular disease or mortality.
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Affiliation(s)
- Jedidiah I Morton
- Baker Heart and Diabetes Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Peter A Lazzarini
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia; Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
| | - Kevan R Polkinghorne
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Nephrology, Monash Health, Clayton, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Australia
| | - Bendix Carstensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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15
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Estimating the benefits of obesity prevention on productivity: an Australian perspective. Int J Obes (Lond) 2022; 46:1463-1469. [PMID: 35546611 PMCID: PMC9092329 DOI: 10.1038/s41366-022-01133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
Background/objectives Obesity poses one of the biggest public health challenges globally. In addition to the high costs of obesity to the healthcare system, obesity also impacts work productivity. We aimed to estimate the benefits of preventing obesity in terms of years of life, productivity-adjusted life years (PALYs) and associated costs over 10 years. Subjects/methods Dynamic life table models were constructed to estimate years of life and PALYs saved if all new cases of obesity were prevented among Australians aged 20–69 years from 2021 to 2030. Life tables were sex specific and the population was classified into normal weight, overweight and obese. The model simulation was first undertaken assuming currently observed age-specific incidences of obesity, and then repeated assuming all new cases of obesity were reduced by 2 and 5%. The differences in outcomes (years of life, PALYs, and costs) between the two modelled outputs reflected the potential benefits that could be achieved through obesity prevention. All outcomes were discounted by 5% per annum. Results Over the next 10 years, 132 million years of life and 81 million PALYs would be lived by Australians aged 20–69 years, contributing AU$17.0 trillion to the Australian economy in terms of GDP. A 5% reduction in new cases of obesity led to a gain of 663 years of life and 1229 PALYs, equivalent to AU$262 million in GDP. Conclusions Prevention of obesity is projected to result in substantial economic gains due to improved health and productivity. This further emphasises the need for public health prevention strategies to reduce this growing epidemic.
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16
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Lee M, Ashton M. Categories. AUSTRALASIAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.34239/ajops.v5n1.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Editors-in-Chief Mark Lee and Mark Ashton propose a holistic categorisation system that is more reflective of urgency and less prone to manipulation or ‘turning off’ in times of pressure.
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17
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Banker KK, Liew D, Ademi Z, Owen AJ, Afroz A, Magliano DJ, Zomer E. The Impact of Diabetes on Productivity in India. Diabetes Care 2021; 44:2714-2722. [PMID: 34675058 DOI: 10.2337/dc21-0922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/23/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes increases the risk of premature mortality and considerably impacts on work productivity. We sought to examine the impact of diabetes in India, in terms of excess premature mortality, years of life lost (YLL), productivity-adjusted life years (PALYs) lost, and its associated economic impact. RESEARCH DESIGN AND METHODS A life table model was constructed to examine the productivity of the Indian working-age population currently aged 20-59 years with diabetes, followed until death or retirement age (60 years). The same cohort was resimulated, hypothetically assuming that they did not have diabetes. The total difference between the two cohorts, in terms of excess deaths, YLL and PALYs lost reflected the impact of diabetes. Data regarding the prevalence of diabetes, mortality, labor force dropouts, and productivity loss attributable to diabetes were derived from published sources. RESULTS In 2017, an estimated 54.4 million (7.6%) people of working-age in India had diabetes. With simulated follow-up until death or retirement age, diabetes was predicted to cause 8.5 million excess deaths (62.7% of all deaths), 42.7 million YLL (7.4% of total estimated years of life lived), and 89.0 million PALYs lost (23.3% of total estimated PALYs), equating to an estimated Indian rupee 176.6 trillion (U.S. dollars 2.6 trillion; purchasing power parity 9.8 trillion) in lost gross domestic product. CONCLUSIONS Our study demonstrates the impact of diabetes on productivity loss and highlights the importance of health strategies aimed at the prevention of diabetes.
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Affiliation(s)
- Khyati K Banker
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Afsana Afroz
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Dianna J Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Zomer E, Rhee Y, Liew D, Ademi Z. The Health and Productivity Burden of Depression in South Korea. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:941-951. [PMID: 34169486 DOI: 10.1007/s40258-021-00649-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Major depression in South Korea, which remains under-diagnosed and under-treated, increases the risk of premature death, and reduces quality of life and work productivity. The aim of this study was to quantify the depression-related health and productivity loss in South Korea in terms of life-years lost and productivity-adjusted life-years (PALYs) lost. METHOD Age and sex-specific life table models simulated follow-up of South Koreans with depression aged 15 to 54 years, until 55 years. Depression was defined as major depression. Inputs were drawn from national datasets and published sources. Models were constructed for the cohort with depression and repeated assuming they had no depression. Differences in total deaths, years of life, and PALYs represented the impact of depression. PALYs were ascribed a financial value equivalent to total gross domestic product (GDP) divided by the number of equivalent full-time workers (KRW81,507,146 or USD74,748). All outcomes were discounted by 3% per annum. RESULTS In 2019, there were more than 500,000 people aged 15-54 years with major depression in South Korea. We predicted that until this cohort reached age 55 years, and assuming 22.2% of people with depression are treated, depression led to 12,000 excess deaths, more than 55,000 discounted years of life lost and 1.6 million discounted PALYs lost, equating to KRW133 trillion (USD122 billion) in lost GDP. Applying treatment-related response and remission rates of 11.8% and 42.1%, respectively, and a non-response/non-remission rate of 46.1%, increased the total number of PALYs lost by almost 6.0%. CONCLUSIONS Our study highlights the considerable productivity loss attributable to depression among South Koreans over their working lifetime. Better prevention and treatment of depression is needed for long-term economic gains.
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Affiliation(s)
- Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - YongJoo Rhee
- Department of Health Sciences, College of Natural Science, Dongduk Women's University, Yeji #406, Hwarang-ro 13-gil, Seongbuk-gu, Seoul, 02748, South Korea.
- Department of Psychiatry and Behavioural Sciences, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Baek Y, Ademi Z, Paudel S, Fisher J, Tran T, Romero L, Owen A. Economic Evaluations of Child Nutrition Interventions in Low- and Middle-Income Countries: Systematic Review and Quality Appraisal. Adv Nutr 2021; 13:282-317. [PMID: 34510178 PMCID: PMC8803532 DOI: 10.1093/advances/nmab097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/24/2021] [Accepted: 07/27/2021] [Indexed: 11/12/2022] Open
Abstract
Economic evaluation is crucial for cost-effective resource allocation to improve child nutrition in low and middle-income countries (LMICs). However, the quality of published economic evaluations in these settings is not well understood. This systematic review aimed to assess the quality of existing economic evaluations of child nutrition interventions in LMICs and synthesize the study characteristics and economic evidence. We searched 9 electronic databases, including MEDLINE, with the following concepts: economic evaluation, children, nutrition, and LMICs. All types of interventions addressing malnutrition, including stunting, wasting, micronutrient deficiency, and overweight, were identified. We included economic evaluations that examined both costs and effects published in English peer-reviewed journals and used the Drummond checklist for quality appraisal. We present findings through a narrative synthesis. Sixty-nine studies with diverse settings, perspectives, time horizons, and outcome measures were included. Most studies used data from sub-Saharan Africa and South Asia and addressed undernutrition. The mortality rate, intervention effect, intervention coverage, cost, and discount rate were reported as predictors among studies that performed sensitivity analyses. Despite the heterogeneity of included studies and the possibility of publication bias, 81% of included studies concluded that nutrition interventions were cost-effective or cost-beneficial, mostly based on a country's cost-effectiveness thresholds. Regarding quality assessment, the studies published after 2016 met more criteria than studies published before 2016. Most studies had well-stated research questions, forms of economic evaluation, interventions, and conclusions. However, reporting the perspective of the analyses, justification of discount rates, and describing the role of funders and ethics approval were identified as areas needing improvement. The gaps in the quality of reporting could be improved by consolidated guidance on the publication of economic evaluations and the use of appropriate quality appraisal checklists. Strengthening the evidence base for child malnutrition across different regions is necessary to inform cost-effective investment in LMICs. Trial registration: PROSPERO CRD42020194445.
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Affiliation(s)
- Yeji Baek
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susan Paudel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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20
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Asakura E, Ademi Z, Liew D, Zomer E. Productivity burden of hypertension in Japan. Hypertens Res 2021; 44:1524-1533. [PMID: 34446919 DOI: 10.1038/s41440-021-00731-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/18/2021] [Accepted: 06/10/2021] [Indexed: 12/26/2022]
Abstract
In the present study, we aimed to estimate the impact of hypertension in the working-age Japanese population. We developed life table models to estimate total deaths, years of life lived, and productivity-adjusted life years lived (a newly developed metric for quantifying the burden of acute and chronic health conditions on work productivity) among Japanese individuals with hypertension aged 20-64 years, with simulated follow-up until age 65 years. Data inputs were drawn from local population statistics and published sources. Gross domestic product per person employed, a measure of labor productivity, was used to assign an economic value to each productivity-adjusted life year lived. Outcomes and costs were discounted by 2% annually. In 2017, 26.3 million Japanese individuals aged 20-64 years (37.5%) had hypertension. Of these people, 23.7% were treated and had controlled blood pressure, 23.2% were treated but had uncontrolled blood pressure, and 53.1% were untreated. During the simulated follow-up until age 65 years, 335,342 deaths (28.0% of total deaths), 1.6 million years of life (0.8% of total), 3.1 million productivity-adjusted life years (1.9% of total), and US$242.9 billion or 28.3 trillion Japanese yen of gross domestic product were lost to hypertension. Our findings highlight the considerable economic burden of hypertension in Japan, as well as the importance of effective strategies for hypertension prevention and management, which are likely to deliver a significant return on investment.
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Affiliation(s)
- Eri Asakura
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Abstract
Objectives To identify whether it is feasible to develop a mapping algorithm to predict presenteeism using multiattribute measures of health status. Methods Data were collected using a bespoke online survey in a purposive sample (n = 472) of working individuals with a self-reported diagnosis of Rheumatoid arthritis (RA). Survey respondents were recruited using an online panel company (ResearchNow). This study used data captured using two multiattribute measures of health status (EQ5D-5 level; SF6D) and a measure of presenteeism (WPAI, Work Productivity Activity Index). Statistical correlation between the WPAI and the two measures of health status (EQ5D-5 level; SF6D) was assessed using Spearman’s rank correlation. Five regression models were estimated to quantify the relationship between WPAI and predict presenteeism using health status. The models were specified based in index and domain scores and included covariates (age; gender). Estimated and observed presenteeism were compared using tenfold cross-validation and evaluated using Root mean square error (RMSE). Results A strong and negative correlation was found between WPAI and: EQ5D-5 level and WPAI (r = − 0.64); SF6D (r =− 0.60). Two models, using ordinary least squares regression were identified as the best performing models specifying health status using: SF6D domains with age interacted with gender (RMSE = 1.7858); EQ5D-5 Level domains and age interacted with gender (RMSE = 1.7859). Conclusions This study provides indicative evidence that two existing measures of health status (SF6D and EQ5D-5L) have a quantifiable relationship with a measure of presenteeism (WPAI) for an exemplar application of working individuals with RA. A future study should assess the external validity of the proposed mapping algorithms. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02936-9.
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Parker C, Liew D, Ademi Z, Owen AJ, Ayton D, Wei A, Zomer E. Estimating the Productivity Impact of Acute Myeloid Leukemia in Australia Between 2020 and 2029, Using a Novel Work Utility Measure: The Productivity-Adjusted Life Year (PALY). JCO Oncol Pract 2021; 17:e1803-e1810. [PMID: 33979179 DOI: 10.1200/op.20.00904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Acute myeloid leukemia (AML) is a rare hematologic malignancy accounting for 0.8% of new cancer diagnoses in Australia. High mortality and morbidity affect work productivity through workforce dropout and premature death. This study sought to estimate the productivity loss attributable to AML in the Australian population over 10 years and to estimate the costs of this productivity loss. Productivity was measured using productivity-adjusted life years (PALYs), a similar concept to quality-adjusted life years, but adjusts for the productivity loss attributable to disease, rather than impaired health. MATERIALS AND METHODS Dynamic life tables modeled the Australian working population (age 15-65 years) between 2020 and 2029. The model population had two cohorts: those with and without AML. Differences in life years, PALYs, and costs represented the health and productivity impact of AML. Secondary analyses evaluated the impact of different scenarios. RESULTS Over the next 10 years, there will be 7,600 years of life lost and 7,337 PALYs lost because of AML, amounting to Australian dollars (AU$) 1.43 billion in lost gross domestic product ($971 million in US dollars). Secondary analyses highlight potential savings of approximately AU$52 million if survival rates were improved by 20% and almost AU$118 million in savings if the return-to-work rates increased by 20% on the current estimates. CONCLUSION Our study demonstrates that even in low-incidence cancer, high mortality and morbidity translate to profound impacts on years of life, productivity, and the broader economy. Better treatment strategies are likely to result in significant economic gains. This highlights the value of investing in research for improved therapies.
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Affiliation(s)
- Catriona Parker
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia.,Department of Haematology, The Alfred Hospital, Melbourne, Australia
| | - Danny Liew
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia.,Department of Haematology, The Alfred Hospital, Melbourne, Australia
| | - Zanfina Ademi
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Alice J Owen
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Darshini Ayton
- Department of General Medicine, The Alfred Hospital, Melbourne, Australia
| | - Andrew Wei
- Monash University, Health and Social Care Unit, Melbourne, Australia.,Monash University, Central Clinical School, Melbourne, Australia
| | - Ella Zomer
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
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23
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Productivity-adjusted life-years: new measure of disease burden. PHARMACOECONOMICS & OUTCOMES NEWS 2021; 870:25. [PMID: 33500609 PMCID: PMC7819827 DOI: 10.1007/s40274-021-7428-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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