Years Of Potential Productive Life Lost Research Articles

Assessing a decade of leukaemia-related premature mortality costs: impact on productivity loss in Spain.

Cancer mortality is one of the dominant causes of productivity loss; and within all cancer sites, blood cancer is the fourth most common cause of death in Spain. Thus, its impacts in work productivity are a major concern and represent a high social impact. The aim of this study was to evaluate the productivity losses resulting from of premature deaths due to leukaemia in Spain. The productivity costs stemming from premature mortality due to leukaemia were estimated using the human capital method. Information pertaining to mortality rates, typical incomes, and joblessness figures was gathered throughout a decade-long period spanning from 2012 to 2021. Leukaemia caused 40% of haematological malignancies losses. It represented a 3.39% of all cancer-related deaths. In addition, it was responsible for 7,851 years of potential productive life lost (YPLPLL) in 2021, and productivity losses of €4,206.52million over the 10-year period. All these numbers are relevant for Spain as will help on a more efficient distribution of resource. These productivity losses obtained, highlight the burden of leukaemia on the Spanish population, providing novel data on the number of deaths, trends and productivity losses for this type of cancer. This evaluation offers fresh insights that can aid policymakers in efficiently distributing resources, thereby lessening the economic burden it imposes on individuals of working age.

Contrasting clinical outcomes and socio-economic impact of young versus elderly-onset oral squamous cell carcinoma, a novel health economic analysis.

The incidence of young-onset oral squamous cell carcinoma (OSCC) is growing, even among non-smokers/drinkers. The effects of adverse histopathological features on long-term oncologic outcomes between the young and old are controversial and confounded by significant heterogeneity. Few studies have evaluated the socio-economic impact of premature mortality from OSCC. Our study seeks to quantify these differences and their economic impact on society. Four hundred and seventy-eight young (<45 years) and 1660 old patients (≥45 years) with OSCC were studied. Logistic regression determined predictors of recurrence and death. Survival analysis was calculated via the Kaplan-Meier method. A separate health economic analysis was conducted for India and Singapore. Years of Potential Productive Life Lost (YPPLL) were estimated with the Human Capital Approach, and premature mortality cost was derived using population-level data. Adverse histopathological features were seen more frequently in young OSCC: PNI (42.9% vs. 35%, p = 0.002), LVI (22.4% vs. 17.3%, p = 0.013) and ENE (36% vs. 24.5%, p < 0.001). Although 5-year OS/DSS were similar, the young cohort had received more intensive adjuvant therapy (CCRT 26.9% vs. 16.6%, p < 0.001). Among Singaporean males, the premature mortality cost per death was US $396,528, and per YPPLL was US $45,486. This was US $397,402 and US $38,458 for females. Among Indian males, the premature mortality cost per death was US $30,641, and per YPPLL was US $595. This was US $ 21,038 and US $305 for females. Young-onset OSCC is an aggressive disease, mitigated by the ability to receive intensive adjuvant treatment. From our loss of productivity analysis, the socio-economic costs from premature mortality are substantial. Early cancer screening and educational outreach campaigns should be tailored to this cohort. Alongside, more funding should be diverted to genetic research, developing novel biomarkers and improving the efficacy of adjuvant treatment in OSCC.

Estimativa de Produtividade Perdida Atribuída a Doenças Cardiovasculares na América do Sul

Abstract Background: Cardiovascular diseases (CVD) have significant health and economic burdens. In South America, the loss of productivity related to these diseases has not yet been well explored. Objective: Estimate the potentially productive years of life lost (PPYLL) and loss of productivity related to premature mortality associated with CVD in South America, in 2019. Methods: Mortality data available from the 2019 Global Burden of Disease Study were used to estimate the burden of disease attributable to CVD. For monetary calculations of productivity loss, a proxy of the human capital approach was used. Data were stratified by sex, in working age groups. Results: The total number of deaths due to CVD in South America in 2019 was 754,324, and the total number of PPYLL was 2,040,973. The total permanent loss of productivity was approximately US$ 3.7 billion and US$ 7.8 billion in purchasing power parity, equivalent to 0.11% of the gross domestic product. The cost per death was US$ 22,904, and the ratio between men and women for the cost per death was 1.45. The variation in scenarios indicates that the estimates are robust, even with important differences between countries. Conclusions: CVD impose a significant economic burden on countries in South America. The characterization of this burden can support governments in the allocation of resources for the planning and execution of health policies and interventions in promotion, prevention, and recovery.

Estimated Loss of Productivity Attributed to Cardiovascular Diseases in South America.

Cardiovascular diseases (CVD) have significant health and economic burdens. In South America, the loss of productivity related to these diseases has not yet been well explored. Estimate the potentially productive years of life lost (PPYLL) and loss of productivity related to premature mortality associated with CVD in South America, in 2019. Mortality data available from the 2019 Global Burden of Disease Study were used to estimate the burden of disease attributable to CVD. For monetary calculations of productivity loss, a proxy of the human capital approach was used. Data were stratified by sex, in working age groups. The total number of deaths due to CVD in South America in 2019 was 754,324, and the total number of PPYLL was 2,040,973. The total permanent loss of productivity was approximately US$ 3.7 billion and US$ 7.8 billion in purchasing power parity, equivalent to 0.11% of the gross domestic product. The cost per death was US$ 22,904, and the ratio between men and women for the cost per death was 1.45. The variation in scenarios indicates that the estimates are robust, even with important differences between countries. CVD impose a significant economic burden on countries in South America. The characterization of this burden can support governments in the allocation of resources for the planning and execution of health policies and interventions in promotion, prevention, and recovery.

The economic impact of cancer mortality among working-age individuals in Brazil from 2001 to 2030

BackgroundAbout half of cancer deaths in Brazil occur among individuals of working-age (under 65 years for men, under 60 for women), resulting in a substantial economic impact for the country. We aimed to estimate the years of potential productive life lost (YPPLL) and value the productivity lost due to premature deaths from cancer between 2001 and 2015 and the projected to 2030. MethodsWe used the Human Capital Approach to estimate the productivity losses corresponding to YPPLL for cancer deaths in working age people (15–64 years). Mortality data were obtained from the Mortality Information System from 2001 to 2015 and projected between 2016 and 2030. Economic data were obtained from the Continuous National Household Sample Survey and forecasted to 2030. Productivity lost was calculated as the monetary value arising from YPPLL in Int$(2016). ResultsBetween 2001 and 2030, a total of 2.3 million premature deaths from all cancers combined were observed and forecasted in Brazil (57% men, 43% women), corresponding to 32 million YPPLL and Int$141.3 billion in productivity losses (men: Int$102.5 billion, women: Int$38.8 billion). Between 2001 and 2030, among men, lung (Int$ 12.6 billion), stomach (Int$ 10.6 billion) and colorectal (Int$ 9.4 billion) cancers were expected to contribute to the greatest productivity losses; and among women, it will be for breast (Int$ 10.0 billion), cervical (Int$ 6.4 billion) and colorectal (Int$ 3.2 billion) cancers. ConclusionsMany preventable cancers result in high lost productivity, suggesting measure to reduce smoking prevalence, alcohol consumption, physical inactivity and inadequate diet, improving screening programs and increasing vaccination coverage for human papillomavirus and hepatitis B would have a positive impact on the economy, as well as reducing morbidity and mortality from cancer.

RETRACTED: Cancer mortality trends in South Africa: 1997.

Upon the addition of the numbers corresponding to various cancer anatomical locations in the report published by Statistics South Africa (StatsSA), the absolute number and proportion of deaths due to all cancers increased from 36726 (8.0%) in 2013 to 40460 (8.5%) in 2015. These high figures suggest that malignant neoplasms were in fact the second-most frequent cause of death in South Africa (SA) in 2013, and moved to the first rank in 2015. To support the initiative aimed at reducing cancer mortality in SA. To this purpose, we assessed trends in cancer mortality rates among males and females in SA from 1997 to 2016 to better understand the increasing threat of cancer mortality in SA. The general mortality data for the period 1997 - 2016, as captured from death certificates in SA, was retrieved from StatsSA. Agestandardised mortality rates (ASMR) for each year were computed using the world standard population structure proposed by Segi as the reference population. The adjusted rates were reported per 100000 population per year. The years of potential productive life lost (YPPLL) due to cancer deaths were calculated for each age group and gender. There were 681 689 total cancer deaths from 1997 to 2016, with 51.1% males and 48.9% females. Males had higher mortality rates than females. The ASMR ranged from 105.0 to 129.2 and 67.9 to 88.3 per 100000 population per year among males and females, respectively. In 2004, the cancer mortality rate increased significantly among males (129.2 per 100000 population), which was 1.5times higher than in females (88.3 per 100000 population). Among males, cancer of the lung had the highest YPPLL (394779.3), followed by oesophageal (253989.4) and liver (207911.0). The YPPLL for cancer of the cervix (647855.5) ranked first, followed by breast (483863.6) and lung (146304.6) in females. Cancer mortality rates have increased since 1997, regardless of gender. Overall, there was a decline in YPPLL for cancer in the young population, while it increased in the adult population. A significant reduction in cancer deaths could be achieved by broadly applying effective interventions.

EE245 Years of Potential Productive Life Lost Mortality Caused By Injury in Mongolia

According to the report from the National Statistics Office of Mongolia, by the end of 2020, the total population of Mongolia will stand at 3.3 million. In the years 2016-2020, the population increased by an average of 58.0-60.6 thousand, which is a growth of 1.8%. Objective of the study was to estimate the Years of Potential Productive Life Lost (YPPLL) in Mongolia.

The economic impact of premature mortality in Cabo Verde: 2016-2020.

Mortality analysis studies in Cabo Verde are scarce and those available are limited to short periods of analysis and to specific population groups. National mortality data reports do not quantify the burden of disease associated with premature mortality. This study estimated the years of potential life lost (YPLL), years of potential productive life lost (YPPLL) and the costs associated with them in Cabo Verde from 2016 to 2020 and aimed to determine trends of early mortality due to all causes of death. Mortality data were obtained from the Ministry of Health, Cabo Verde. Deaths that occurred from 2016 to 2020, in individuals aged between one (1) and 73 years old were analyzed by sex, age group, municipality and cause of death. YPLL, YPPLL and cost of productivity lost (CPL) were estimated using life expectancy and the human capital approach methods, respectively. There were 6100 deaths recorded in the sample population and males represented 68.1% (n = 4,154) of the reported deaths. The number of deaths verified corresponded to 145,544 YPLL, of which 69.0% (n = 100,389) were attributed to males. There were 4,634 deaths among individuals of working age, which resulted in 80 965 YPPLL, with males contributing 72.1% (n = 58,403) of the total YPPLL. The estimated CPL due to premature death was 98,659,153.23 USD. Injuries and external causes together accounted for 21,580,954.42 USD (21.9%) of CPL, while diseases of the circulatory system 18,843,260.42 USD (19.1%) and certain infectious and parasitic diseases accounted for 16,633,842.70 USD (16.9%). The study demonstrated the social and economic burden of premature mortality. The YPLL, YPPLL and CPL measures can be used to complement measures traditionally used to demonstrate the burden and loss of productivity due to premature mortality and to support resource allocation and public health decision making in Cabo Verde.

An Exploration of Productivity Costs and Years of Potential Life Lost: Understanding the Impact of Premature Mortality From Injury in Mongolia.

This study estimates the years of potential life lost (YPLL), years of potential productive life lost (YPPLL), and cost of productivity loss (CPL) owing to injury-related mortalities in Mongolia. By implementing a retrospective cohort study, the study used secondary mortality data for Mongolia from 2016 to 2020 from the Health Development Center. Our study incorporates information on 13 551 fatalities from injuries and external factors, with the aim of estimating YPLL, YPPLL, and CPL associated with the leading causes injury-induced deaths. These include exposure to toxic substances, road accidents, homicides, suicides, and falls. Our findings reveal majority of the losses occur because of exposure to poisonous chemicals, road accidents, suicides, falls, and homicides. Furthermore, 444 550 years of potential life are lost owing to injury-related mortalities, in which YPPLL accounts for 338 482 years. The CPL caused by these premature deaths during the study period accounts for $1.368 billion. Notably, YPLL, YPPLL, and CPL rates are significantly higher in males than in females. The YPLL from exposure to poisonous chemicals is higher than those caused by other factors. This study is the first to calculate the CPL owing to YPLL from injury in Mongolia.

Model-based estimation of burden of COVID-19 with disability-adjusted life years and value of statistical life in West Bengal, India

ObjectivesThe COVID-19 pandemic has posed unprecedented challenges to health systems and populations, particularly in India. Comprehensive, population-level studies of the burden of disease could inform planning, preparedness and policy, but...

The cost of lost productivity due to premature mortality associated with COVID-19: a Pan-European study.

BackgroundEconomic cost estimates have the potential to provide a valuable alternative perspective on the COVID-19 burden. We estimate the premature mortality productivity costs associated with COVID-19 across Europe.MethodsWe calculated excess deaths between the date the cumulative total of COVID-19 deaths reached 10 in a country to 15th May 2020 for nine countries (Belgium, France, Germany, Italy, The Netherlands, Portugal, Spain, Sweden and Switzerland). Gender- and age-specific excess deaths and Years of Potential Productive Life Lost (YPPLL) between 30 and 74 years were calculated and converted into premature mortality productivity costs €2020 for paid and unpaid work using the Human Capital and the Proxy Good Approaches. Costs were discounted at 3.5%.ResultsTotal estimated excess deaths across the nine countries were 18,614 (77% in men) and YPPLL were 134,190 (77% male). Total paid premature mortality costs were €1.07 billion (87% male) with Spain (€0.35 billion, 33.0% of total), Italy (€0.22 billion; 20.6%) and The Netherlands (€0.19 billion; 17.5%) ranking highest. Total paid and unpaid premature mortality costs were €2.89 billion (77% male). Premature mortality costs per death ranged between €40,382 (France) and €350,325 (Switzerland). Spain experienced the highest premature mortality cost as a proportion of Gross Domestic Product (0.11%).ConclusionEven in the initial period of the pandemic in Europe, COVID-19-related premature mortality costs were significant across Europe. We provide policy makers and researchers with a valuable alternative perspective on the burden of the virus and highlight potential economic savings that may be accrued by applying timely public health measures.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10198-021-01351-8.

Estimation of the economic burden of COVID-19 using disability-adjusted life years (DALYs) and productivity losses in Kerala, India: a model-based analysis

ObjectivesFrom the beginning of the COVID-19 pandemic, clinical practice and research globally have centred on the prevention of transmission and treatment of the disease. The pandemic has had a huge...

Years of potential life lost and productivity costs due to premature mortality from six priority diseases in Tanzania, 2006-2015.

BackgroundMortality statistics are traditionally used to quantify the burden of disease and to determine the relative importance of the various causes of death. Some of the most frequently used indices to quantify the burden of disease are the years of potential life lost (YPLL) and years of potential productive life lost (YPPLL). These two measures reflect the mortality trends in younger age groups and they provide a more accurate picture of premature mortality. This study was carried out to determine YPLL, YPPLL and cost of productivity lost (CPL) due to premature mortality caused by selected causes of deaths in Tanzania.Methods and findingsMalaria, respiratory diseases, HIV/AIDS, tuberculosis, cancers and injuries were selected for this analysis. The number of deaths by sex and age groups were obtained from hospital death registers and ICD-10 reporting forms in 39 public hospitals in Tanzania, covering a period of 2006–2015. The life expectancy method and human capital approach were used to estimate the YPLL, YPPLL and CPL due to premature mortality. During 2006–2015, malaria, HIV/AIDS, tuberculosis, respiratory diseases, HIV+tuberculosis, cancer and injury were responsible for a total of 96,834 hospital deaths, of which 46.4% (n = 57,508) were among individuals in the productive age groups (15–64 years). The reported deaths contributed to 2,850,928 YPLL (female = 1,326,724; male = 1,524,205) with an average of 29 years per death. The average YPLL among females (32) was higher than among males (28). Malaria (YPLL = 38 per death) accounted for over one-third (35%) of the total YPLL. There was a significant increase in YPLL due to the selected underlying causes of death over the 10-year period. Deaths from the selected causes resulted into 1,207,499 YPPLL (average = 21 per death). Overall, HIV/AIDS contributed to the highest YPPLL (323,704), followed by malaria (243,490) and injuries (196,505). While there was a general decrease in YPPLL due to malaria, there was an increase of YPPLL due to HIV/AIDS, respiratory diseases, cancer and injuries during the 10-year period. The total CPL due to the six diseases was US$ 148,430,009 for 10 years. The overall CPL was higher among males than females by 29.1%. Over half (58%) of the losses were due to deaths among males. HIV/AIDS accounted for the largest (29.2%) CPL followed by malaria (17.8%) and respiratory diseases (14.6%). The CPL increased from US$11.4 million in 2006 to US$17.9 million in 2016.ConclusionsThe YPLL, YPPLL and CPL due to premature death associated with the six diseases in Tanzania are substantially high. While malaria accounted for highest YPLL, HIV/AIDS accounted for highest YPPLL and CPL. The overall CPL was higher among males than among females. Setting resource allocation priorities to malaria, HIV/AIDS and respiratory diseases that are responsible for the majority of premature deaths could potentially reduce the costs of productivity loss in Tanzania.

Gender Differences in Labour Losses Associated with Smoking-Related Mortality.

The aim of this paper was to estimate the number of premature deaths, years of potential productive life lost (YPPLL) and labour losses attributable to tobacco smoking due to premature death by gender for the Spanish population. The human capital approach was applied. Employment, gross wage and death data were obtained from the Spanish National Institute of Statistics. Relative risks of death due to cigarette smoking and former smoking were applied. The base case used an annual discount rate of 3% and an annual labour productivity growth rate of 1%. Univariate deterministic sensitivity analysis was performed on discount rates and labour productivity growth rates. Between 2002 and 2016, smoking was estimated to cause around 13,171–13,781 annual deaths in the population under 65 years of age (legal retirement age) in Spain. This increase was mostly due to female deaths. YPPLLs for females have increased over the years, while for males they have fallen markedly. Labour losses associated with smoking mortality ranged from €2269 million in 2002 to €1541 in 2016 (base year 2016). In fact, labour productivity losses have decreased over the years for men (−39.8%) but increased sharply for women (101.6%). The evolution of monetary value of lost productivity due to smoking mortality shows clearly differentiated trends by gender.

Labour Productivity Losses Associated with Breast Cancer: An Analysis Along A Decade in Spain

In Spain, breast cancer is the most frequently diagnosed tumor in women, with an estimated prevalence of 104,210 cases, being the leading cause of death in tumors in women with more than 6,000 annual deaths. A relevant aspect of this disease is, given the average age of the women affected, its negative impact on the work environment. The main aim is to estimate the labour losses associated with breast cancer in women in Spain along a decade: 2005-2014. Data was collected from several official sources (Registration of Deaths, Labor Force Survey and Wage Structure Survey). All of them were conducted by National Statistics Institute from the 2005 to 2014. It was performed simulation models based on the human capital approach to estimate labour productivity losses flows due to premature deaths, adjusted by employment and wage rates for each age group. It was calculated years of potential productive life lost (YPLL). A total of 61,445 women died due breast cancer in the period considered (22,716 of death in working age). The total YPLL is estimated in 292,848. The estimated productivity losses amounted to 2,137.32 million throughout the period (base year 2014). This figure range between 1,672.59 to 2,907.34 in the sensibility analysis. Breast cancer caused the 3.3% of total women deaths, the 11.7% of total women deceases in working age and the 10.0% of total YPLL and the 10.45% of women labour productivity losses estimated in the period considered. In spite of therapeutic advances produced in the last decade, breast cancer caused a strong impact in terms of premature deaths, years of potential productive life lost and labour productivity losses in women. The results obtained might be useful to improve knowledge about the economic impact of such disease and to incorporate this information into economic assessments into social perspective.

The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden

BackgroundMost measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland.MethodsAll cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009.ResultsTotal YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million.ConclusionLost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than females reflects higher wages and rates of workforce participation. Productivity costs provide an alternative perspective on the cancer burden on society and may inform cancer control policy decisions.

CA4 - Measuring the Cost of Lost Productivity Due to Premature Cancer-related Mortality: A European Overview

Objectives To assess the economic burden of cancer by estimating years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality across Europe. Methods We derived the number of cancer deaths by sex for 23 of the most common cancer sites in 30 European countries from GLOBOCAN. YPPLL were calculated by multiplying the number of cancer-specific deaths for each productive age group (15-64) by standard life expectancy at the mid-point for each age group. Using the human capital approach, we multiplied standardised YPPLL for each individual by country- age- and gender-specific annual wages from age of death until retirement following adjustments for labour force participation and unemployment. Costs were expressed in 2008€. Results All cancer sites combined generated a total of €150.9 billion in premature mortality costs in Europe in 2008. Western Europe accounted for almost half of the total, followed by Northern (21%), Southern (21%) and Central & Eastern Europe (9%). Findings contrasted with YPPLL where Central & Eastern Europe had the highest burden. Male costs exceeded female costs by 88% in Europe as a whole (male: €98.4 billion; female: €52.5 billion) and across all European regions. Lung was the most expensive site (€34.7 billion; 23% of total costs), followed by breast cancer (€13.6 billion, 9%), colorectal cancer (€12.1 billion, 8%), brain & CNS (€9.1 billion, 6%) and pancreatic cancer (€7.5 billion, 5%). According to premature mortality cost per death, testicular cancer was the most expensive site (€2.5 million per death), followed by brain & CNS cancer (€481,512) and Hodgkin lymphoma (€474,559). Conclusions Lost productivity costs due to cancer-related premature mortality are significant in Europe. Productivity costs provide an alternative perspective on the cancer burden on society and may inform cancer control policy decisions.

Employment status and indirect costs in patients with renal failure: differences between different modalities of renal replacement therapy.

There are evidences of a different employment status between patients undergoing different modalities of renal replacement therapy (RRT). The present study aims to compare the indirect costs associated to morbidity in the following RRT alternatives: hemodialysis in a specialized center (HD), automated peritoneal dialysis (APD), continuous ambulatory dialysis (CAPD), and renal transplant (TX). An analysis on indirect costs was implemented following the Human Capital Theory. In total, 243 patients in working age were included (32 CAPD, 46 APD, 83 HD and 82 TX) from 8 hospitals. The potentially productive years of life lost (PPYL), the costs of lost labor productivity (LLPc) for the year 2009 and the total cost of PPYL (PPYLtc) until age of retirement were estimated. All the estimations were adjusted by age, sex rates. Non-parametric analysis (a bootstrap confidence intervals of differences in costs calculated following the simple bias-corrected percentile method -1,000 estimates-) was computed to highlight differences in costs. No significant differences were found in age or sex between groups. LLPc-2009- in HD (6,547€-95% CI: 5,727€-7,366€) was significantly higher (p<.001) than TX (5,079€-95% CI: 4,127€-6,030€) or APD (4,359€-95% CI: 3,064€-5,655€) but not CAPD (5,785€-95% CI: 4,302€-7,269€). PPYLs were: HD 12.58 years-95% CI: 10.42-14.73; TX 10.05-95% CI: 7.45-12.65; APD 6.09-95% CI: 3.43-8.74; CAPD 10.69-95% CI: 6.14-15.23. PPYLtc was higher in HD than in TX, APD or CAPD in all the provided scenarios. TX and, specially, APD are the modalities of RRT with the lowest impact on indirect costs due to morbidity showing higher rates of employment than HD and requiring less disability benefits.

Costos económicos de la mortalidad evitable en Cartagena, Colombia, 2000-2005

Evaluating the economic cost of loss of human capital produced by preventable deaths in Cartagena, 2000-2005, from estimating years of potential life lost (YPLL) and the percentage of years of potential productive life lost (YPPLL). This was a mixed ecological study, using 2000-2005 time series. Mortality data was taken from the Colombian National Administrative Department of Statistics (DANE) records. Cases of preventable death were classified according to Taucher's guidelines. YPLL and YPPLL were used as indicators. Deaths were adjusted by adopting WHO-recommended Bennett-Horiuchi methodology for accounting for underreporting. Two scenarios were assumed: a minimum or flat scenario and an upper or roof scenario. Once YPLL for each annual period had been established, they were multiplied by minimum income according to scenario. Epidat 3.0 software was used for analysing the database. There were 20,723 preventable deaths (adjusted for underreporting). One out of every three preventable deaths which occurred in Cartagena could have been averted by early diagnosis and medical treatment, according to Taucher. Violent deaths are the kind of avoidable deaths which produce higher costs according to the information processing (IPC) model adopted in this study. Reducing preventable deaths by early diagnosis and medical treatment would cause a significant reduction in avoidable mortality.

Años de vida perdidos por muerte prematura (AVPP) en adultos del Gran Santiago: ¿Hemos ganado con equidad?

Potentially productive years of life lost (PPYLL) is an impact measure that illustrates the lost that a society suffers as a consequence of deaths of young people or premature deaths. To study the evolution of PPYLL in adults in the periods 1994-1996 and 1999-2001, according to sex, income quintiles and main diagnostic groups in the communities of Metropolitan Santiago. Ecological study analyzing the population of Metropolitan Santiago, that represents 36% of the national population. A total of 87,969 deaths in people aged 20 to 79 years were analyzed. There is a greater amount of PPYLL among the poorest quintiles and men represent the higher number of PPYLL. In the different analyzed periods, all quintiles experienced a reduction in PPYLL. According to diagnosis, endocrine diseases experienced the greater decrease between periods, followed by respiratory disease. Noteworthy was the increase of PPYLL due to infectious diseases. PPYLL due to digestive diseases was 2.3 higher in the poorest quintile, as compared with the wealthiest quintile (20/20 ratio). The ratio for traumatic disease was 1.8. When comparing both periods, there is a net gain of potentially productive years of life in all income quintiles and in both genders.