Productivity losses associated with Fetal Alcohol Spectrum Disorder in New Zealand.

AIM: To estimate the productivity losses due to morbidity and premature mortality of individuals with Fetal Alcohol Spectrum Disorder (FASD) in New Zealand (NZ). METHODS: A demographic approach with a counterfactual scenario in which nobody in NZ is born with FASD was used. Estimates were calculated using (Census Year) 2013 data for the NZ population, the labour force, unemployment rate and average weekly wage, all of which were obtained from Statistics NZ. In order to estimate the number of FASD cases in 2013 and the related morbidity, the prevalence of FASD, obtained from the available epidemiological literature, was applied to the general population of NZ. Assumptions made on the level of impairment that would affect the ability of individuals with FASD to participate in the workforce or would reduce their productivity were based on data obtained from the current epidemiological literature. RESULTS: In 2013, approximately 0.03% of the NZ workforce experienced a loss of productivity due to FASD-attributable morbidity and premature mortality, which translated to aggregate losses ranging from $NZ49 million to $NZ200 million - that is, 0.03% to 0.09% of the annual gross domestic product in NZ. These costs represent estimates for lost productivity attributable to FASD and do not include additional costs incurred by governmental and private entities including social costs, such as both higher costs and or less effective spending by the education, health and justice systems. CONCLUSION: The estimated productivity losses associated with FASD further reinforces that effective FASD prevention as a primary public health strategy may be of significant value.

The cost of lost productivity due to fetal alcohol spectrum disorder-related premature mortality.

BACKGROUND: Individuals with Fetal Alcohol Spectrum Disorder (FASD) have increased mortality as compared to the general population. OBJECTIVES: To estimate the productivity losses due to premature mortality of individuals with FASD in Canada in 2011. METHODS: A demographic approach with a counterfactual scenario in which nobody in Canada is born with FASD was used. Population estimates were calculated using data on the labour force, unemployment rate, and average weekly wage obtained from Statistics Canada. The number of FASD-related deaths, coded in the International Classification of Diseases, version 10, was estimated based on data from Statistics Canada and pooled prevalence estimates of the major disease conditions associated with FASD were obtained from a meta-analysis. The estimates of FASD-related mortality rates served as a basis for the length of working life span estimation. Once the number of working years lost to premature deaths was derived, productivity losses were computed. RESULTS: It was estimated that in total 327 individuals with FASD aged 20 to 69 (almost twice as many men as women) died in Canada in 2011. As a result, there were 2,877 years of potential employment lost, which translated to a loss ranging from $88 million to $126 million. This amount represents the increase in national income, had there been no premature mortality from FASD and the workers with FASD had been typical members of the labour force (without compromised productivity due to FASD). CONCLUSIONS: The estimates of productivity losses further reinforce the value of FASD prevention as a primary strategy.

Productivity losses because of morbidity attributable to fetal alcohol spectrum disorder in Canada: a demographic approach.

OBJECTIVE: The purpose of this study was to estimate the productivity losses due to morbidity of individuals with fetal alcohol spectrum disorder (FASD). METHOD: A demographic approach was used. Population estimates were calculated using data for the most recent available year (i.e., 2011) on the population of Canada by provinces, the labor force, unemployment rate, and the average weekly wage, all of which were obtained from Statistics Canada. To estimate the number of FASD cases in Canada in 2011, the prevalence of FASD, obtained from the available epidemiological literature, was applied to the general population of Canada. Assumptions made on the level of impairment that would affect the ability of individuals with FASD to participate in the workforce or reduce their productivity were based on data obtained from the current epidemiological literature and experts' opinions. To estimate the cost of FASD, a counterfactual scenario was used with an assumption that there is no one born with FASD in Canada. RESULTS: About 0.03% of the Canadian workforce experiences a loss of productivity because of FASD-attributable morbidity, which translates to aggregate losses ranging from $418 million Canadian dollars (CND) to $1.08 billion CND annually. CONCLUSIONS: FASD imposes a considerable economic toll on Canadian society and therefore requires more preventive efforts.

Analgesics do not interfere with diagnosing abdominal pain.

Despite the limitations in this review, it seems appropriate to administer analgesics to patients with generalized abdominal pain, even before a surgical evaluation. Surgeons can be assured that they will not be misled as a result of analgesia.

The New Zealand health reforms of the 1990s in context.

The New Zealand health sector reforms of the 1990s have to be seen in the context of the long term development of the New Zealand health system. The evolutionary change between 1938 and 1990 was abruptly replaced by the revolutionary policy of commercialization from 1991 to 1993. This proved unsatisfactory, with the promised benefits such as significant productivity increases not occurring. In some ways the system functioned even more imperfectly, although this was in part due to the funding cutbacks which took place at the same time. The policy shifts from the mid 1990s have largely taken the New Zealand health system back to where it would have been, had the evolution up to 1990 continued. There remains unfinished business, the largest of which is that the tensions between the managers and the health professionals have not been resolved. The New Zealand experience provides strong evidence that comprehensive commercialization--business practices within, market relations between institutions--will not make a significant contribution to the design of effective health systems.