Abstract
BackgroundThe high acute costs of cardiovascular disease and acute cardiovascular events are well established, particularly in terms of direct medical costs. The costs associated with lost work productivity have been described in a broad sense, but little is known about workplace absenteeism or short term disability costs among high cardiovascular risk patients. The objective of this study was to quantify workplace absenteeism (WA) and short-term disability (STD) hours and costs associated with cardiovascular events and related clinical procedures (CVERP) in United States employees with high cardiovascular risk.MethodsMedical, WA and/or STD data from the Truven Health MarketScan® Research Databases were used to select full-time employees aged 18–64 with hyperlipidemia during 2002–2011. Two cohorts (with and without CVERP) were created and screened for medical, drug, WA, and STD eligibility. The CVERP cohort was matched with a non-CVERP cohort using propensity score matching. Work loss hours and indirect costs were calculated for patients with and without CVERP and by CVERP type. Wages were based on the 2013 age-, gender-, and geographic region-adjusted wage rate from the United States Bureau of Labor Statistics.ResultsA total of 5,808 WA-eligible, 21,006 STD-eligible, and 3,362 combined WA and STD eligible patients with CVERP were well matched to patients without CVERP, creating three cohorts of patients with CVERP and three cohorts of patients without CVERP. Demographics were similar across cohorts (mean age 52.2-53.1 years, male 81.3-86.8 %). During the first month of follow-up, patients with CVERP had more WA/STD-related hours lost compared with patients without CVERP (WA-eligible: 23.4 more hours, STD-eligible: 51.7 more hours, WA and STD-eligible: 56.3 more hours) (p < 0.001). Corresponding costs were $683, $895, and $1,119 higher, respectively (p < 0.001). Differences narrowed with longer follow-up. In the first month and year of follow-up, patients with coronary artery bypass graft experienced the highest WA/STD-related hours lost and costs compared with patients with other CVERP.ConclusionsCVERP were associated with substantial work loss and indirect costs. Prevention or reduction of CVERP could result in WA and STD-related cost savings for employers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0925-x) contains supplementary material, which is available to authorized users.
Highlights
The high acute costs of cardiovascular disease and acute cardiovascular events are well established, in terms of direct medical costs
Patient selection A total of 1,065,292 patients with a diagnosis of hyperlipidemia or use of lipid-lowering medications were selected for the time period 2002 to 2011 (Fig. 1)
5,808, 21,006 and 3,362 matched pairs of patients with and without Cardiovascular events and related clinical procedures (CVERP) were available for respective analysis of workplace absenteeism (WA), short-term disability (STD) and combined benefits
Summary
The high acute costs of cardiovascular disease and acute cardiovascular events are well established, in terms of direct medical costs. The costs associated with lost work productivity have been described in a broad sense, but little is known about workplace absenteeism or short term disability costs among high cardiovascular risk patients. The objective of this study was to quantify workplace absenteeism (WA) and short-term disability (STD) hours and costs associated with cardiovascular events and related clinical procedures (CVERP) in United States employees with high cardiovascular risk. Total CVD-related direct medical costs accounted for an estimated 17 % of overall health expenditures in the United States in 2005 dollars [5]. In 2010, CVD-related direct medical costs in the United States were $273 billion and CVD-related indirect costs were $172 billion [2]. By 2030, the indirect costs of CVD are expected to increase to $276 billion [2]
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