Productivity-related Costs Research Articles

Productivity Losses Among Treated Depressed Patients Relative to Healthy Controls

Estimate the productivity-related cost of depression in an employed population. By using administrative data, annual short-term disability (STD) and absenteeism costs ($2005) were compared for patients with depression and treated with antidepressants and for a matched control group without depression. Mean annual STD costs were $1038 among treated depressed patients versus $325 among controls and $1685 among a subgroup of severely depressed treated patients versus $340 among their controls. After controlling for demographic and employment characteristics, treated patients with depression had STD costs that were $356 higher per patient and those with severe depression had costs that were $861 higher. The marginal impact of treated depression on absenteeism was $377. Even when depressed patients are treated with antidepressants, there are substantial productivity losses. Therapies that can better manage depression may provide opportunities for savings to employers.

Costs Associated With Changes in Antidepressant Treatment in a Managed Care Population With Major Depressive Disorder

Costs Associated With Changes in Antidepressant Treatment in a Managed Care Population With Major Depressive Disorder

Direct and Indirect Costs to Employers of Patients With Systemic Lupus Erythematosus With and Without Nephritis

To estimate the medical- and productivity-related cost burden of systemic lupus erythematosus (SLE) and SLE with nephritis in an employee population. Using administrative data, annual costs were calculated for SLE patients, a subset with nephritis, and a matched control group of patients without SLE. These costs were compared with the cost of other chronic conditions. Mean annual medical expenditures and short term disability costs for SLE patients were $12,238 and $1184 greater (2005 dollars), respectively, than those of controls. Mean medical expenditures for SLE/nephritis patients were $46,862 greater than for controls. When compared with other chronic health conditions faced by employees, SLE/nephritis was the most costly condition. SLE, particularly with nephritis, is associated with substantial costs. Therapies that can better manage SLE may provide opportunities for savings to employers.

Cost-effectiveness of transanal irrigation versus conservative bowel management for spinal cord injury patients

Cost-effectiveness analysis following international guidelines and taking the societal viewpoint. To estimate the cost-effectiveness of transanal irrigation using a self-administered irrigation system when compared with conservative bowel management. A randomized clinical trial was conducted at five spinal centres situated in Denmark, Germany, Italy, United Kingdom and Sweden. Estimates of resources and unit costs were made for the German health care system. Efficacy outcomes were drawn from a randomized controlled trial conducted in 2003-2005. Adult spinal cord-injured patients with neurogenic bowel dysfunction were randomized to 10 weeks with either transanal irrigation using Peristeen Anal Irrigation or to conservative bowel management. Costs were calculated based on results from the clinical trial and on 24 interviews conducted in Germany. Unit costs were obtained from the Federal Statistical Office Germany and product list prices. When comparing outcome measures at termination, transanal irrigation significantly reduced symptoms of neurogenic bowel dysfunction. Product-related costs were higher for transanal irrigation using the self-administered system; however, costs for a carer to help with bowel management and changes/washing due to leakage were lower. For transanal irrigation, costs associated with urinary tract infections and patient time spent were reduced. Thus, the total cost to society is lower when patients use transanal irrigation. The results were shown to be robust in the sensitivity analysis. Transanal irrigation using a self-administered system reduces symptoms of neurogenic bowel dysfunction and results in a lower total cost to society than conservative bowel management. The study was supported by Coloplast A/S.

The life cycle costs of indoor climate systems in dwellings and offices taking into account system choice, airflow rate, health and productivity

The life cycle cost (LCC) of the heating, cooling and ventilation system was simulated for a typical cell office building, multi-family dwelling and detached house. Different ventilations systems were simulated resulting in different heating and cooling system designs. A health-related cost dependent on the airflow rate which was based on recent studies was added to the LCC for the dwellings as well as a productivity cost for the office building. An optimal airflow rate can be found depending on the assumed size of the health or productivity-related cost. The results for the office building indicate that a much higher outdoor supply airflow rate at presence, as well as a cooling system, is appropriate from a LCC perspective even if the influence on the human being still should be taken with precaution. With that higher airflow rate, the results show that there is a clear benefit with variable airflow rate ventilation systems. For dwellings, there is also a clear benefit from higher airflow rates even if the optimal airflow rate in the presented examples was not much higher than common requirements. Furthermore, it is not well known or defined how to valuate that possible influence. Despite this, this study is the demonstration of a method which can be used to optimize airflow rates in buildings if the influence and costs on human health related to the airflow rate is known.

Optimal scheduling of parallel machines with constrained resources

This paper analyzes a manufacturing system consisting of parallel machines, which produce one product-type with controllable production rates subject to continuously-divisible, time-dependent resources. The objective is to produce the required amount of product-type units by a due date while minimizing inventory, backlog and production related costs over a production horizon. With the aid of the maximum principle, a number of analytical rules of the optimal scheduling is derived whereby the continuous-time scheduling is reduced to discrete sequencing and timing. As a result, a polynomial-time algorithm is developed for solving the problem.

Two-echelon distribution-inventory supply chain model for the bread industry using genetic algorithm

The core issue in achieving a focused approach for the improvement of supply chain distribution inventory management is the optimisation of the inventory level adopted by various supply chain entities. This paper presents an approach of optimising the inventory level for a two-echelon supply chain by considering the distribution costs and various production related costs in meeting the customer demand. This methodology is devised for a single product based on the assumption that the total demand of customers for all periods should be less than the limited production capacity and inventory level of plant and warehouse. The focus is to determine the optimal production rate and cost of the plant, the optimal inventory level of the plant and warehouse and the distribution costs for two-echelon in each period by optimising the entire supply chain using genetic algorithm based distribution inventory model (GADIM).

Granulocyte Colony-Stimulating Factor for Chemotherapy-Induced Neutropenia in Patients with Small Cell Lung Cancer

Recombinant granulocyte colony-stimulating factor (G-CSF) [filgrastim and lenograstim] and pegylated G-CSF (pegfilgrastim) have been shown to reduce the severity and duration of chemotherapy-associated febrile neutropenia (FN) when administered prophylactically to cancer patients receiving chemotherapeutic regimens. The American Society of Clinical Oncology (ASCO) evidence-based clinical guidelines published in 1994, 1996 and 1997 recommended primary prophylaxis with G-CSF for cancer patients. The 2000 ASCO update, with the same recommendation, highlights the importance of economic considerations in decision making for CSFs. This paper reviews the available cost-effectiveness evidence on the use of G-CSF as primary prophylaxis against FN in patients with small cell lung cancer (SCLC).Cost-effectiveness ratios from a healthcare payer perspective supported the use of filgrastim as primary prophylaxis for people with SCLC, on the basis of both clinical and economic benefits, treated with chemotherapeutic regimens that have an FN rate in the range of 40-60%. However, when indirect and patient out-of-pocket costs attributable to severe FN are included, available evidence suggests that the risk threshold may be reduced by more than half. Given that FN rates associated with chemotherapeutic regimens for SCLC are generally <40%, then few circumstances would warrant the use of G-CSFs (filgrastim and lenograstim) under the current rule. However, inclusion of indirect costs would lower the cost-effectiveness threshold. Future cost-effectiveness studies of medications such as pegfilgrastim should attempt to capture the societal perspective by incorporating productivity-related costs and using base-case rates of FN reported in the literature.

FORMALIZING PRODUCT COST DISTORTION: The Impact of Volume-Related Allocation Bases on Cost Information

The purpose o f this study is to formally analyze product cost distortions resulting from the process of allocating costs to products based on Activity-Based Costing (ABC) and the conventional product costing systems. The model developed in this paper rigorously shows the impact of treating costs that are not volume related as if they are. The model demonstrates that the source of product cost distortion is the difference between the proportion of driver used by each product in ABC and the proportion of the base used by the same product in the conventional costing systems. The difference arises because the conventional costing systems ignore the existence of batch-related and product-related costs. The model predicts a positive association between volume and size diversity with product cost distortions. When interaction between volume and size diversity exists, the distortion is either mitigated or exacerbated. The magnitude of the distortion is jointly determined by the size of the differences and the size of the total indirect costs.

Depression: We've Come a Long Way!

Depression: We've Come a Long Way!

Economic costs of diabetes in the US in 2002.

Diabetes is the fifth leading cause of death by disease in the U.S. Diabetes also contributes to higher rates of morbidity-people with diabetes are at higher risk for heart disease, blindness, kidney failure, extremity amputations, and other chronic conditions. The objectives of this study were 1). to estimate the direct medical and indirect productivity-related costs attributable to diabetes and 2). to calculate and compare the total and per capita medical expenditures for people with and without diabetes. Medical expenditures were estimated for the U.S. population with and without diabetes in 2002 by sex, age, race/ethnicity, type of medical condition, and health care setting. Health care use and total health care expenditures attributable to diabetes were estimated using etiological fractions, calculated based on national health care survey data. The value of lost productivity attributable to diabetes was also estimated based on estimates of lost workdays, restricted activity days, prevalence of permanent disability, and mortality attributable to diabetes. RESULTS-Direct medical and indirect expenditures attributable to diabetes in 2002 were estimated at 132 billion US dollars. Direct medical expenditures alone totaled 91.8 billion US dollars and comprised 23.2 billion US dollars for diabetes care, 24.6 billion US dollars for chronic complications attributable to diabetes, and 44.1 billion US dollars for excess prevalence of general medical conditions. Inpatient days (43.9%), nursing home care (15.1%), and office visits (10.9%) constituted the major expenditure groups by service settings. In addition, 51.8% of direct medical expenditures were incurred by people >65 years old. Attributable indirect expenditures resulting from lost workdays, restricted activity days, mortality, and permanent disability due to diabetes totaled 39.8 billion US dollars. U.S. health expenditures for the health care components included in the study totaled 865 billion US dollars, of which 160 billion US dollars was incurred by people with diabetes. Per capita medical expenditures totaled 13243 US dollars for people with diabetes and 2560 US dollars for people without diabetes. When adjusting for differences in age, sex, and race/ethnicity between the population with and without diabetes, people with diabetes had medical expenditures that were approximately 2.4 times higher than expenditures that would be incurred by the same group in the absence of diabetes. The estimated 132 billion US dollars cost likely underestimates the true burden of diabetes because it omits intangibles, such as pain and suffering, care provided by nonpaid caregivers, and several areas of health care spending where people with diabetes probably use services at higher rates than people without diabetes (e.g., dental care, optometry care, and the use of licensed dietitians). In addition, the cost estimate excludes undiagnosed cases of diabetes. Health care spending in 2002 for people with diabetes is more than double what spending would be without diabetes. Diabetes imposes a substantial cost burden to society and, in particular, to those individuals with diabetes and their families. Eliminating or reducing the health problems caused by diabetes through factors such as better access to preventive care, more widespread diagnosis, more intensive disease management, and the advent of new medical technologies could significantly improve the quality of life for people with diabetes and their families while at the same time potentially reducing national expenditures for health care services and increasing productivity in the U.S. economy.

The cost of epilepsy in the United States: an estimate from population-based clinical and survey data.

To provide 1995 estimates of the lifetime and annual cost of epilepsy in the United States using data from patients with epilepsy, and adjusting for the effects of comorbidities and socioeconomic conditions. Direct treatment-related costs of epilepsy from onset through 6 years were derived from billing and medical chart data for 608 population-based incident cases at two sites in different regions of the country. Indirect productivity-related costs were derived from a survey of 1,168 adult patients visiting regional treatment centers. Direct costs separate the effects of epilepsy and comorbidity conditions. Indirect costs account for the effects of other disabilities and socioeconomic conditions on foregone earnings and household activity. The estimates were applied to 1995 population figures to derive national projections of the lifetime and annual costs of the disorder. The lifetime cost of epilepsy for an estimated 181,000 people with onset in 1995 is projected at $11.1 billion, and the annual cost for the estimated 2.3 million prevalent cases is estimated at $12.5 billion. Indirect costs account for 85% of the total and, with direct costs, are concentrated in people with intractable epilepsy. Direct costs attributable to epilepsy are below previous estimates. Indirect costs adjusted for the socioeconomic conditions of patients are above previous estimates. Findings indicate that epilepsy is unique in the large proportion of costs that are productivity-related, justifying further investment in the development of effective interventions.

The development of a quality cost model in a telecommunications company

This paper describes the processes used to develop a model and its relevant checklists for studying quality costs at a company which produces telecommunications facilities. Company documents were analysed in the first instance in order to appreciate the organizational structure, and both the quality and production systems. A preliminary cost study was then carried out using a simple checklist based on BS 6143 (Part 2). From this, a new quality cost system was proposed to investigate both quality system management and production-related costs. Each was broken down into detailed quality cost elements according to the department or process. Both the PAF and process cost models, together with their variants, were used to account for the associated quality costs.

The Productivity Costs of Providing or Withholding Treatment

To the Editor. —Dr Eddy 1 has written yet another excellent article. To be complete, the following principle should be inserted (probably as No. 3) on his list: Because illness-related productivity losses have the same economic impact on society as direct health care expenditures, it is also valid and appropriate to consider the productivity-related costs of providing or withholding treatment. An optimally healthy workforce bestows a tremendous competitive advantage. This has been recognized by armies since antiquity (disease-related losses exceeded battlefield losses in most wars), by nations (the success of the British navy in part through the use of limes to prevent scurvy), and by modern corporations (which invest in the health of the workforce). While this literature is young and the measures of productivity and productive capacity are imperfect, it appears that for many if not most diseases, the lost productivity costs exceed the cost of medical treatment. 2

Food Production Forecasting with Simple Time Series Models

This article applies simple mathematical (time series) models often used in other industries to food and beverage operations. Technology transfer of management science techniques is imperative for survival and to gain the competitive edge. Improved forecasting is critical to efficient food and beverage operations since all production-related costs are impacted by this basic decision. Simple models with minimal data storage were employed in this study and yielded better performance than the naive model.

Cost-Volume-Profit Analysis Adjusted for Learning

A model is developed for cost-volume-profit analysis which incorporates a nonlinear cost function to express the effects of employee learning. Sensitivity analysis is applied to the model to assess the impact of estimation errors in the learning rate and steady-state production time on estimated profit and break-even quantities. The paper also examines the effects on the model of (1) alternative accounting treatments of production-related costs, and (2) continuous learning due to employee turnover.