Household Income Losses Associated With Ischaemic Heart Disease For US Employees
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Pharmacoeconomics 2000 Mar 17 (3): 305-314 1170-7690/00/0004-0305/$20.00/0 61 © Adis International Limited. All rights reserved.
Household Income Losses Associated With Ischaemic Heart Disease For US Employees Jeph Herrin,1 Charles B. Cangialose,2 Stephen J. Boccuzzi,3 William S. Weintraub 4 and David J. Ballard 5 1 National Institute of Public Health, Oslo, Norway 2 Health Services Research Centre, Victoria University of Wellington and Wellington School of Medicine, Wellington, New Zealand 3 Merck & Co. Inc., West Point, Pennsylvania, USA 4 Division of Cardiology, Emory University, Atlanta, Georgia, USA 5 Baylor Health Care System, Dallas, Texas, USA
Abstract
Objective: To estimate the cost of lost work days due to ischaemic heart disease (IHD), and the cost of this reduced productivity using reduction in household income. Design and setting: Using 2 years of nationally representative observational data, this study examined the effect on household income of IHD. This effect was estimated after accounting for unemployment, days lost to illness and other effects of illness on the income of workers aged 18 to 64 years. Main outcome measures and results: Previous measures of indirect costs of disease have typically not included the loss in productivity due to suboptimal work performance. Among workers in this age group, IHD was associated with a reduction of $US3013 in annual household income; this reduction was independent of occupational class, age, size of household and educational level. Such a reduction may be because of reduced on-the-job performance, employer perception of this, or unrelated lifestyle choices. It represents an estimated $US6.05 billion annual loss in productivity in 1992 dollars (or $US6.45 billion in 1996 dollars). Conclusions: Estimates of the indirect costs of chronic disease that do not account fully for the lost income of employees may significantly underestimate the benefits to employers and society of treatment and prevention.
In 1993, over 7 million people in the US reported having ischaemic heart disease (IHD).[1] Like other chronic illnesses, IHD is a major economic concern to patients, employers and society because of both the costs of treatment and the indirect costs of morbidity and mortality.[2] The purpose of this paper was to estimate one of the in-
direct costs of IHD: reduced household income due to the disease. The economic burden of any disease includes the costs of both disease effects and treatment effects. Direct costs, including costs of treatment, are well understood, and those of heart disease have been estimated in a number of contexts.[3-6] Indirect
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costs, which can include work disability, home care, lost leisure time, wages lost to employees, production lost to employers and the cost to society of foregone tax receipts, are more difficult both to define and to estimate. Furthermore, when given a definition of an indirect cost, it is not always clear which party (society, individual, employer, insurer) is actually bearing it.[7] Several definitions and r
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