PubMed · 12163772
Follow absenteeism and turnover rates from two outpatient clinics that underwent a period of major organizational change marked by multiple ownership.
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Susan E Domagala, Connie J Rowles. 2002. Capacity for change.. https://doi.org/10.1097/00006247-200207000-00019
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Arthritis is the leading cause of disability in the United States, potentially limiting affected persons from walking a few blocks or climbing a flight of stairs. Using Medical Expenditure Panel Survey (MEPS) data, CDC analyzed national and state-specific direct costs (i.e., medical expenditures) and indirect costs (i.e., lost earnings) attributable to arthritis and other rheumatic conditions (AORC) in the United States during 2003. This report describes the results of that analysis, which indicated that, in 2003, the total cost of AORC in the United States was approximately 128 billion dollars (80.8 billion dollars in direct and 47.0 billion dollars in indirect costs), equivalent to 1.2% of the 2003 U.S. gross domestic product. Total costs attributable to AORC, by state/area, ranged from 225.5 million dollars in the District of Columbia to 12.1 billion dollars in California. Total costs attributable to AORC have increased substantially since 1997, and that increase is expected to continue because of the aging of the population and increases in obesity and physical inactivity. These findings signal the need for broader implementation of effective public health interventions, such as arthritis and chronic disease self-management programs, which can reduce medical expenditures among persons with AORC.
This study assessed the loss of utility and indirect costs associated with first cardiovascular events. Data was collected (using EQ-5D) prospectively at 3, 6, and 12 months following an event in the Swedish part of the Anglo-Scandinavian cardiac outcomes trial (ASCOT), including patients with mild to moderate hypertension and additional risk factors. Sixty patients were eligible for analysis. An event was associated with a one-year utility loss of 0.075 (95% CI: 0.038-0.114). For a stroke, the reduction was 0.145 (CI: 0.059-0.249) and for acute coronary syndromes (myocardial infarction or unstable angina) the loss was 0.051 (-0.003 to 0.103). The utility at baseline was no different to the utility in a control group. The indirect cost over the first 12 months (2003 Swedish Kronor, SEK) was 90028 SEK (CI: 46027-146754), 9866 euro for patients in the workforce. These results are helpful in future economic evaluations of primary preventive measures in cardiovascular medicine.
In this paper, we analyze exits from long-term sickness spells in Sweden. Using data for more than 2,500 people, the aim is to analyze the transition to different states: return to work, full disability pension, partial disability pension, and other exits from the labor force. Given the complexity of the exit decision, which encompasses both the individual's choice, the medical evaluation and the decision of the insurance adjudicator, we consider the outcome as being the result of two aspects of the exit process: one that governs the duration of a spell prior to the decision to exit, and another that governs the type of exit. Therefore, the analysis is done in two steps: first, we analyze the duration of the sickness spells, and then we analyze the process that governs the type of exit. The results indicate that both individual characteristics and push factors, such as regional unemployment, are important for both components of the decision process.