RT Journal Article
SR Electronic
T1 Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 429
OP 437
DO 10.1136/ard.61.5.429
VO 61
IS 5
A1 A Boonen
A1 D van der Heijde
A1 R Landewé
A1 A Spoorenberg
A1 H Schouten
A1 M Rutten-Van Mölken
A1 F Guillemin
A1 M Dougados
A1 H Mielants
A1 K de Vlam
A1 H van der Tempel
A1 Sj van der Linden
YR 2002
UL http://ard.bmj.com/content/61/5/429.abstract
AB Objective: To compare work disability, sick leave, and productivity costs due to ankylosing spondylitis (AS) of three European countries. Methods: 216 patients with AS from the Netherlands, France, and Belgium participated in a two year observational study. Employment and work disability rates at baseline were adjusted for age and sex. Productivity costs were calculated by both the friction cost method and the human capital approach. The adjusted contributions of country to employment, work disability, and having an episode of sick leave were assessed by logistic regression and the contribution of the country to days of sick leave and costs by Cox proportional hazard analysis. Results: 209 patients completed the two years' follow up with sufficient data for cost analysis. Adjusted employment was 55% in the Netherlands as compared with 72% in both other countries and only in the Netherlands was it lower than expected in the general population. Adjusted work disability was 41%, 23%, and 9% in the Netherlands, France, and Belgium and in all countries was higher than expected in the general population. In those with a paid job, the mean number of days of sick leave per patient per year because of AS was 19 (range 0–130), six (range 0–77), and nine (range 0–60 ) in the Netherlands, France, and Belgium respectively. Applying the friction cost method to those with a paid job resulted in mean costs per patient per year of 1257 euros (range 0–7356), 428 euros (range 0–5979), and 476 euros (range 0–2354) in the Netherlands, France, and Belgium. Applying the human capital approach to the whole group resulted in mean costs per patient per year of 8862 euros (range 0–46 818), 3188 euros (range 0–43 550), and 3609 euros (range 0–34 320) in the three countries, respectively. After adjusting for sociodemographic and disease characteristics, living in the Netherlands, as compared with both other countries, was associated with a higher chance of being work disabled (odds ratio (OR)=3.82; 95% confidence interval (CI) 1.33 to 11.01), but not with the risk of having an episode of sick leave. Similarly, living in the Netherlands contributed independently to the number of days sick leave (OR=0.65; 95% CI 0.43 to 0.97), a higher amount of friction costs (OR=0.63; 95% CI 0.42 to 0.96), and a higher amount of human capital costs (OR=0.46; 95% CI 0.32 to 0.68). Conclusion: There are remarkable differences in work status and productivity costs between the three European countries. This has implications for the generalisability of health economic studies.