Abstract 13352: Work Absenteeism, Short Term Disability and Related Indirect Costs Associated with Cardiovascular Events and Related Clinical Procedures

Abstract

Objectives: To examine work absenteeism (WA) and short-term disability (STD) hours and related indirect costs associated with cardiovascular events and related procedures (CVERP): myocardial infarction (MI), ischemic stroke (IS), unstable angina (UA), heart failure (HF), transient ischemic attack (TIA), coronary artery bypass graft (CABG), and percutaneous coronary intervention (PCI). Methods: Full-time employees aged 18-64, with WA or STD benefits, hyperlipidemia or lipid-lowering therapy, and ≥1 CVERP in 2003-2011 were extracted from a large claims and productivity database. Index date was the date of the first CVERP. All patients had data for ≥1 year pre-index and ≥1 month post-index. Per patient per month (PPPM) WA and STD hours were measured during the acute 1 month and 1 year post-index periods. Indirect costs associated with these hours were calculated using the Bureau of Labor Statistics wage rates (in 2013 $). Results: A total of 5,803 patients were included in the WA analysis (mean age 53, 86% male, mean Charlson comorbidity index [CCI] 0.6) and 21,074 in the STD analysis (mean age 53, 82% male, mean CCI 0.7). Patients with CABG as the first CVERP type had the highest mean PPPM costs and hours during the acute 1 month and the 1 year post-index periods (Fig. 1), followed by MI (for WA acute 1 month and 1 year, for STD acute 1 month) and HF (for STD 1 year). Mean PPPM WA hours ranged between 31 - 61 (indirect cost: $998 - $1842) and STD hours between 31- 121 (indirect cost: $532 - $2154) during the acute 1 month post-index period. Compared with the mean PPPM hours lost from work in the pre-index period, mean PPPM WA hours went up by 22.5 hours (indirect cost by $647) in the acute 1 month post-index period, and STD went up by 53 hours ($916). Conclusions: CVERP were associated with substantial work loss and related indirect costs, especially in the acute first month period following CVERP. Prevention of CVERP could result in potential WA and STD related cost savings for employers.