RESUMO
OBJECTIVE: The aim of the study is to estimate COVID-19 absenteeism and indirect costs, by care setting. METHODS: A population-based retrospective cohort study using data from the German Statutory Health Insurance (SHI) database to define outpatient (April 2020-December 2021) and hospitalized (April 2020-October 2022) cohorts of employed working-aged individuals. RESULTS: In the outpatient cohort ( N = 369,220), median absenteeism duration and associated cost was 10.0 (Q1, Q3: 5.0, 15.0) days and 1061 (530, 1591), respectively. In the hospitalized cohort ( n = 20,687), median absenteeism and associated cost was 15.0 (7.0, 32.0) days and 1591 (743, 3394), respectively. Stratified analyses showed greater absenteeism in older workers, those at risk, and those with severe disease. CONCLUSIONS: The hospitalized cohort had longer absenteeism resulting in higher productivity loss. Being older, at risk of severe COVID-19 and higher disease severity during hospitalization were important drivers of higher absenteeism duration.
Assuntos
Absenteísmo , COVID-19 , Eficiência , Hospitalização , Humanos , COVID-19/economia , COVID-19/epidemiologia , Alemanha/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Hospitalização/estatística & dados numéricos , Hospitalização/economia , SARS-CoV-2 , Efeitos Psicossociais da Doença , Adulto Jovem , IdosoRESUMO
OBJECTIVE: Osteoarthritis (OA) affects 10% of adults in the UK. Despite over one-third of people with OA experiencing chronic pain, few studies have examined the population-level impact of chronic pain associated with OA. We compared resource-use and epidemiological outcomes in patients with mild, moderate and severe chronic OA-associated pain and matched controls without known OA. DESIGN: Retrospective, longitudinal, observational cohort study (July 2008 to June 2019). SETTING: Electronic records extracted from Clinical Practice Research Datalink GOLD primary care linked to Hospital Episode Statistics (HES). PARTICIPANTS: Patients (cases; n=23 016) aged ≥18 years with chronic OA-associated pain. Controls (n=23 016) without OA or chronic pain matched on age, sex, comorbidity burden, general practitioner practice and available HES data. INTERVENTIONS: None. PRIMARY AND SECONDARY OUTCOME MEASURES: Total healthcare resource use (HCRU), direct healthcare costs in 0-12, 12-24 and 24-36 months postindex. Secondary outcomes included incidence and prevalence of chronic OA-associated pain and pharmacological management. RESULTS: HCRU was consistently greater in cases versus controls for all resource categories during preindex and postindex periods. Across follow-up periods, resource use was greatest in patients with severe pain. In the first 12 months postindexing, mean total costs incurred by cases were four times higher versus matched controls (£256 vs £62); costs were approximately twice as high in cases vs controls for months 12-24 (£166 vs £86) and 24-36 (£150 vs £81; all p<0.0001). The incidence of new cases of chronic pain associated with OA was 2.64 per 1000 person-years; the prevalence was 1.4%. CONCLUSIONS: This study highlights the real-world cost of chronic pain associated with OA in cases versus matched controls. We included patients with mild, moderate and severe pain associated with OA, and showed HCRU in discrete 1-year time frames. The true economic burden of pain associated with OA is likely to be considerably higher when indirect costs are considered.
Assuntos
Dor Crônica , Osteoartrite , Adulto , Humanos , Adolescente , Estudos Retrospectivos , Dor Crônica/etiologia , Dor Crônica/complicações , Atenção Secundária à Saúde , Osteoartrite/complicações , Osteoartrite/epidemiologia , Custos de Cuidados de Saúde , Inglaterra/epidemiologiaRESUMO
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with intense and persistent pruritus. OBJECTIVES: To examine associations between AD symptoms and health-related quality of life (HRQoL) in adults (aged ≥18 years) with moderate-to-severe AD. MATERIALS & METHODS: Patient chart and survey data from physicians within Europe were derived from the Adelphi AD Disease Specific Programme (Q3 2019-Q2 2020). HRQoL measures included Euro-Qol 5-dimension, 3-level, questionnaire; Dermatology Life Quality Index; and Work Productivity and Activity Impairment-Atopic Dermatitis questionnaire. Data were evaluated using descriptive statistics and generalized linear models. RESULTS: Of 631 patients, 90.1%, 49.3%, 18.5% and 17.7% reported pruritus, sleep disruption, anxiety and depression, respectively. Adjusted analyses indicated an increased frequency of symptoms associated with worse HRQoL and greater work/activity impairments, particularly for patients with pruritus and sleep disruption. CONCLUSION: Reductions in symptom frequency may have important implications for improving the overall health of patients with moderate-to-severe AD.