The Impact of Rheumatoid Arthritis on Medical Expenditures, Absenteeism, and Short-Term Disability Benefits

Institute for Health and Productivity Studies, Cornell University, New York, NY, USA.
Journal of Occupational and Environmental Medicine (Impact Factor: 1.63). 03/2006; 48(2):135-48. DOI: 10.1097/01.jom.0000194161.12923.52
Source: PubMed


The objectives of this study were to estimate medical expenditures, absenteeism, and short-term disability costs for workers with rheumatoid arthritis (RA) and to estimate the relative costs of RA over a 12-month period.
Using data from nine U.S. employers, direct and indirect costs for 8502 workers with RA were compared with costs for a matched group without RA. Regression analyses controlled for factors that were different even after propensity score matching.
Average total costs for workers with RA were $4244 (2003 dollars) greater than for workers without RA. RA was the fourth most costly chronic condition per employee compared with cancers, asthma, bipolar disorder, chronic obstructive pulmonary disease, depression, diabetes, heart disease, hypertension, low back disorders, and renal failure.
RA is a costly disorder and merits consideration as interventions are considered to improve workers' health and productivity.

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    • "To estimate costs of short-term disability, the number of short-term disability days was multiplied by a $28.70/hr wage constant as a result of the observation that average wage replacement tends to be 70% of wages while on disability. This 70% figure is consistent with previously published studies [19,20]. "
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    ABSTRACT: Background Adults with certain comorbid conditions have a higher risk of pneumonia than the overall population. If treatment of pneumonia is more costly in certain predictable situations, this would affect the value proposition of populations for pneumonia prevention. We estimate the economic impact of community-acquired pneumonia (CAP) for adults with asthma, diabetes, chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) in a large U.S. commercially-insured working age population. Methods Data sources consisted of 2003 through 2007 Thomson Reuters MarketScan Commercial Claims and Encounters and Thomson Reuters Health Productivity and Management (HPM) databases. Pneumonia episodes and selected comorbidities were identified by ICD-9-CM diagnosis codes. By propensity score matching, controls were identified for pneumonia patients. Excess direct medical costs and excess productivity cost were estimated by generalized linear models (GLM). Results We identified 402,831 patients with CAP between 2003 through 2007, with 25,560, 32,677, 16,343, and 5,062 episodes occurring in patients with asthma, diabetes, COPD and CHF, respectively. Mean excess costs (and standard error, SE) of CAP were $14,429 (SE=44) overall. Mean excess costs by comorbidity subgroup were lowest for asthma ($13,307 (SE=123)), followed by diabetes ($21,395 (SE=171)) and COPD ($23,493 (SE=197)); mean excess costs were highest for patients with CHF ($34,436 (SE=549)). On average, indirect costs comprised 21% of total excess costs, ranging from 8% for CHF patients to 27% for COPD patients. Conclusions Compared to patients without asthma, diabetes, COPD, or CHF, the excess cost of CAP is nearly twice as high for patients with diabetes and COPD and nearly three times as high for patients with CHF. Indirect costs made up a significant but varying portion of excess CAP costs. Returns on prevention of pneumonia would therefore be higher in adults with these comorbidities.
    BMC Health Services Research 10/2012; 12(1):379. DOI:10.1186/1472-6963-12-379 · 1.71 Impact Factor
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    • "Individuals experience significant reduction in income [36] [88] and it has been reported that average direct medical costs can range from $5425 to $ 10,053 [27] [64] [85]. Those with RA have been reported to have over $4000 more in medical expenses compared with workers without RA [66]. The noneconomic impact of work disability on the individual and family members can also be substantial, such as social participation and household activities [78] [89]. "
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    ABSTRACT: With so many people affected by arthritis and the significant impact it has on themselves and on their families, employers as well as on society, employment of individuals with arthritis is an important topic to consider. A review of literature was conducted to examine the issues that arise from arthritis, factors that influence work disability and employment retention, and interventions and services that are available to promote and retain employment for individuals with arthritis. In recent years, employers have begun to proactively intervene in terms of both prevention activities as well as provision of accommodation. Work disability is a common occurrence for individuals with arthritis and factors that influence work disability for those with arthritis include employment factors, employee factors, disease factors, and other factors such as access to health care and vocational rehabilitation. It is critical to consider the complex interaction of these factors in order for individuals with arthritis to remain productive and future research must consider all of these aspects when developing and implementing interventions.
    Journal of Vocational Rehabilitation 01/2009; 30(2):121-131. DOI:10.3233/JVR-2009-0458
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