Productivity losses associated with diabetes in the US.

OBJECTIVE The objective of this study was to estimate the cost of productivity losses in the U.S. attributable to diabetes, with regard to specific demographic and disease-related characteristics in the U.S.. RESEARCH DESIGN AND METHODS We used the 1989 National Health Interview Survey, a random survey of individuals in the U.S. that included a diabetes supplement. Data on individuals were obtained for labor force participation, hours of work, demographic and occupational characteristics, self-reported health status, and several variables that indicated the presence, duration, and severity (complications) of diabetes. Using multivariate regression analyses, we estimated the association of independent variables (e.g., demographics, health, and diabetes status) with labor force participation, hours of work lost, and the economic value of lost work attributable to diabetes and its complications and duration. RESULTS In general, the presence of diabetes and complications were found to be related to workforce participation variables. The magnitude of the lost-productivity costs depended on personal characteristics and on the presence and status of diabetes. In general, the loss of yearly earnings amounted to about a one-third reduction in earnings and ranged from $3,700 to $8,700 per annum. CONCLUSIONS Diabetes has a considerable net effect on earnings, and the complications and duration of diabetes have compound effects. Our findings have implications for the cost-effectiveness of diabetes control; the presence of complicating factors is the single most important predictive factor in lost productivity costs attributable to diabetes, and thus the avoidance or retardation of complications will have an impact on indirect health-related costs.

[1]  Matthew E. Kahn Health and Labor Market Performance: The Case of Diabetes , 1998, Journal of Labor Economics.

[2]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[3]  N. Ray,et al.  Economic Consequences of Diabetes Mellitus in the U.S. in 1997 , 1998, Diabetes Care.

[4]  T. Songer,et al.  Studies on the Cost of Diabetes , 1998 .

[5]  J. Selby,et al.  Excess Costs of Medical Care for Patients With Diabetes in a Managed Care Population , 1997, Diabetes Care.

[6]  A. Zbrozek,et al.  Model of Complications of NIDDM: II. Analysis of the health benefits and cost-effectiveness of treating NIDDM with the goal of normoglycemia , 1997, Diabetes Care.

[7]  Weiren Wang Semi-parametric estimation of the effect of health on labour force participation of married women , 1997 .

[8]  T. Waidmann,et al.  Race and Education Differences in Disability Status and Labor Force Attachment , 1995 .

[9]  Dora L. Costa,et al.  Health and Labor Force Participation of Older Men, 1900–1991 , 1994, The Journal of Economic History.

[10]  A. Melander,et al.  Comparison of Excess Costs of Care and Production Losses Because of Morbidity in Diabetic Patients , 1994, Diabetes Care.

[11]  D N Mendelson,et al.  Health care expenditures for people with diabetes mellitus, 1992. , 1994, The Journal of clinical endocrinology and metabolism.

[12]  B. Wolfe,et al.  Market Work, Wages, and Men's Health , 1989, Journal of health economics.

[13]  J. Heckman What Has Been Learned about Labor Supply in the Past Twenty Years , 1993 .

[14]  G A Colditz,et al.  The economic costs of non-insulin-dependent diabetes mellitus. , 1989, JAMA.

[15]  J. Heckman,et al.  Female labor supply: A survey , 1986 .

[16]  Dorothy P. Rice,et al.  The economic costs of illness: A replication and update , 1985, Health care financing review.

[17]  Richard V. Burkhauser,et al.  The importance of the measure of health in empirical estimates of the labor supply of older men , 1984 .

[18]  P. Schmidt,et al.  Limited-Dependent and Qualitative Variables in Econometrics. , 1984 .

[19]  J. Lambrinos Health: A Source of Bias in Labor Supply Models , 1981 .

[20]  P. Taubman,et al.  Health and labor market success: the role of various diseases. , 1979, The review of economics and statistics.

[21]  D. Commerce Statistical abstract of the United States , 1978 .

[22]  Reuben Gronau,et al.  Leisure, Home Production, and Work--the Theory of the Allocation of Time Revisited , 1976, Journal of Political Economy.

[23]  J. Heckman,et al.  Estimating Labor Supply Functions , 1972 .

[24]  Y Akazawa,et al.  [Therapy for diabetes]. , 1966, Kangogaku zasshi.

[25]  S. Mushkin,et al.  Economic costs of disease and injury. , 1959, Public health reports.

[26]  J. Ferrell Economics of Public Health. , 1927 .