The personal and national costs of lost labour force participation due to arthritis: an economic study

BMC Public Health

Simon J Kelly³  Emily J Callander²  Megan E Passey¹  Richard Percival³  Rupendra N Shrestha⁴  Deborah J Schofield² 

[1] University Department of Rural Health (North Coast), University of Sydney, Lismore, Australia;Sydney School of Public Health, University of Sydney, Sydney, Australia;National Centre for Social and Economic Modelling, University of Canberra, Canberra, Australia;NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia

关键词: Retirement;    Arthritis;    GDP;    Taxation;    Income;    Economic impacts;   

Others  :  1162491
DOI  :  10.1186/1471-2458-13-188

 received in 2012-06-19, accepted in 2013-02-25,  发布年份 2013

【 摘 要 】

Background

The costs of arthritis to the individuals and the state are considerable.

Methods

Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model.

Results

Individuals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation.

When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65.

Conclusions

The costs of arthritis to the individuals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. Individuals bear the economic costs of lost income and the reduction of their savings over the long term.

【 授权许可】

   
2013 Schofield et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Yelin E, Cisternas M, Foreman A, Pasta D, Murphy L, Helmick C: National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions–-United States, 2003. Morb Mortal Wkly Rep 2007, 56:4-7.
• [2]Reginster J: The prevalence and burden of arthritis. Rheumatology 2002, 41(12):3.
• [3]Australian Institute of Health and Welfare: Australia's Health, 2010. Canberra: AIHW; 2010.
• [4]Australian Institute of Health and Welfare: Australia's Health, 2008. Canberra: AIHW; 2010.
• [5]Access Economics: The economic cost of arthritis in New Zealand. Canberra: Access Economics; 2005. Arthritis New Zealand
• [6]Access Economics: Arthritis - the bottom line: The economic impact of arthritis in Australia. Canberra: Access Economics; 2005. Arthritis Australia
• [7]Health Priority Areas: Health Priority Areas. http://www.aihw.gov.au/nhpa/index.cfm webcite
• [8]Gignac M, Cao X, Lacaille D, Anis A, Badley EM: Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis & Rheumatism (Arthritis Care & Research) 2008, 59(12):1805-1813.
• [9]Schofield D, Shrestha R, Passey M, Earnest A, Fletcher S: Chronic disease and labour force participation among older Australians. Med J Australia 2008, 189:447-450.
• [10]Li X, Gignac M, Anis A: The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Medical Care 2006, 44(4):304.
• [11]Economics A: Painful realities: The economic impact of arthritis in Australia in 2007. Forest Lodge: Arthritis Australia; 2007.
• [12]Dunlop D, Manheim L, Yelin E, Song J, Chang R: The costs of arthritis. Arthritis Rheum 2003, 49(1):101-113.
• [13]Productivity Commission: Economic Implications of an Ageing Australia. Canberra: Australian Government; 2005. [Research Report Productivity Commission Canberra]
• [14]Organisation for Economic Co-operation and Development: Ageing societies. In OECD Factbook 2008. Paris: OECD; 2008.
• [15]Organisation for Economic Co-operation and Development: Labour Force Statistics 1986–2006. Paris: OECD; 2007.
• [16]Schofield D, Shrestha R, Callander E, Percival R, Kelly S, Passey M, Fletcher S: Modelling the cost of ill health in Health&WealthMOD (Version II): lost labour force participation, income and taxation, and the impact of disease prevention. Int J Microsimulation 2011, 4(3):32-36.
• [17]Australian Bureau of Statistics: Information Paper - Basic Confidentialised Unit Record File: Survey of Disability, Ageing and Carers 2003 (reissue). Canberra: Australian Bureau of Statistics; 2005.
• [18]Lambert S, Percival R, Schofield D, Paul S: An Introduction to STINMOD: A Static Microsimulation Model. Canberra: NATSEM; 1994.
• [19]Percival R, Abello A, Vu QN: STINMOD (Static Income Model) 2007. In Modelling Our Future: Population ageing, health and aged care. Edited by Gupta A, Harding A. Amsterdam: Elsevier BV; 2007.
• [20]Rässler S: Statistical matching: A frequentist theory, practical applications, and alternative Bayesian approaches. New York, Inc: New York Springer-Verlag; 2002.
• [21]Australian Bureau of Statistics: Average Weekly Earnings, Australia, Aug 2009. Canberra: ABS; 2009. vol. ABS Cat. No. 6302.0
• [22]Australian Bureau of Statistics: Consumer Price Index, Australia, September 2009. Canberra: ABS; 2009. vol. ABS Cat. No. 6401.0
• [23]Harding A, Kelly S, Percival R, Keegan M: Population Ageing and Government Age Pension Outlays: Using Microsimulation Models to Inform Policy Making. 2009. [Economic and Social Research Institute, Cabinet Office, Government of Japan] http://www.esri.go.jp/jp/workshop/0907/a_02_01.pdf webcite
• [24]Australian Bureau of Statistics: House Price Indexes: Eight Capital Cities, Sep 2009. Canberra: ABS; 2009. vol. ABS Cat. No. 6416.0
• [25]Reserve Bank of Australia: Australian stock market, Table F07. In RBA Bulletin. Sydney: RBA; 2009.
• [26]Reserve Bank of Australia: Retail Deposit and Investment Rates, Table F04. Sydney: RBA; 2009. [RBA Bulletin]
• [27]Wooden M, Watson N: The HILDA survey and its contribution to economic and social research (So Far). Econ Rec 2007, 83(261):208-231.
• [28]Australian Bureau of Statistics: Australian Life Tables 2006–2008. Canberra: ABS; 2009.
• [29]Costello P: Intergenerational report 2007. Canberra: Commonwealth of Australia; 2007.
• [30]Duan N: Smearing estimate: a nonparametric retransformation method. J Am Stat Assoc 1983, 78(3838):605-610.
• [31]Australian Bureau of Statistics: Australian Economic Indicators, July 2012. Canberra: ABS; 2012.
• [32]Toder E, Solanki S: Effects of demographic trends on labour supply and living standards. Washington DC: The Urban Institute; 1999. [The Retirement Project]
• [33]Gregory B, Sheehan P: Poverty and the collapse of full employment. In Australian Poverty: then and now. Edited by Fincher R, Nieuwenhuysen J. Carlton South: Melbourne University Press; 1998.
• [34]Swoboda SM, Lipsett PA: Impact of a prolonged surgical critical illness on patients' families. Am J Crit Care 2002, 11(5):459-466.
• [35]Mills A, Shillcutt S: Communicable diseases. In Global crises, global solutions. Edited by Lomborg B. Cambridge: Cambridge University Press; 2004.
• [36]Australian Institute of Health and Welfare: Health system expenditure on disease and injury in Australia, 2004–05. Canberra: AIHW; 2010.
• [37]Australian Institute of Health and Welfare: Health expenditure for arthritis and musculoskeletal conditions, 2004–05. Canberra: AIHW; 2009.
• [38]Rat A, Boissier M: Rheumatoid arthritis: direct and indirect costs. Joint Bone Spine 2004, 71(6):518-524.
• [39]Wolfe F, Michaud K, Choi HKW R: Household income and earnings losses among 6,396 persons with rheumatoid arthritis. J Rheumatol 2005, 32(10):1875-1883.
• [40]Puolakka K, Kautiainen H, Pekurinen M, Mottonen T, Hannonen P, Korpela M, Hakala M, Arkela-Kautiainen M, Luukkainen R, Leirisalo-Repo M: Monetary value of lost productivity over a five year follow up in early rheumatoid arthritis estimated on the basis of official register data on patients' sickness absence and gross income: experience from the FIN-RACo trial. Ann Rheum Dis 2006, 65(7):899-904.
• [41]Merkesdal S, Ruof J, Schoffski O, Bernitt K, Zeidler H, Mau W: Indirect medical costs in early rheumatoid arthritis: composition of and changes in indirect costs within the first three years. Arthritis Rheum 2001, 44(3):528-534.
• [42]Cai L, Kalb G: Health Status and Labour Force Participation: Evidence from the HILDA Data. Melbourne Institute of AppliEconomic and Social Research; 2004.
• [43]Kohli M, Rein M: The changing balance of work and retirement. In Time for retirement: Comparative Studies of Early Exit from the Labor Force. Edited by Kohli M, Guillemard A, Van Gunsteren H. Cambridge: Cambridge University Press; 1991:1-35.
• [44]Schofield D, Shrestha R, Percival R, Passey M, Kelly S, Callander E: Economic impacts of illness in older workers: quantifying the impact of illness on income, tax revenue and government spending. BMC Publ Health 2011., 11(418)
• [45]Mau W, Bornmann M, Weber H, Weidemann HF, Hecker H, Raspe HH: Prediction of permanent work disability in a follow-up study of early rheumatoid arthritis: results of a tree structured analysis using RECPAM. Br J Rheumatol 1996, 35:652-659.
• [46]Lacaille D, Sheps S, Spinelli JJ, Chalmers A, Esdaile JM: Identification of modifiable work-related factors that influence the risk of work disability in rheumatoid arthritis. Arthritis Rheum 2004, 51(5):843-852.
• [47]Jantti J, Aho K, Kaarela K, Kautiainen H: The long term outcomes of rheumatoid arthritis: work disability: a prospective 18-year study of 823 patients. Rheumatology 1999, 38:1138-1141.
• [48]Yelin E, Katz P, Lubeck D, Wanke L, Buatti M: Impact of etanercept (Enbrel®) on health care use and employment in early RA. Arthritis Rheum 2001, 44(9):152.
• [49]Puolakka K, Kautiainen H, Mottonen T, Hannonen P, Korpela M, Julkunen H, Luukkainen R, Vuori K, Paimela L, Blafield H: Impact of initial aggressive drug treatment with a combination of disease-modifying antirheumatic drugs on the development of work disability in early rheumatoid arthritis: a five-year randomized followup trial. Arthritis Rheum 2004, 50(1):55-62.
• [50]Australian Government: A Plan to Simplify and Streamline Superannuation. Canberra: The Australian Government; 2006.