Ina Rissanen1,2,3, Leena Ala-Mursula4, Iiro Nerg5, Marko Korhonen5. 1. Center for Life Course Health Research, University of Oulu, Oulu, Finland. i.l.rissanen@umcutrecht.nl. 2. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. i.l.rissanen@umcutrecht.nl. 3. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Huispost nr. STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. i.l.rissanen@umcutrecht.nl. 4. Center for Life Course Health Research, University of Oulu, Oulu, Finland. 5. Oulu Business School, Department of Economics, University of Oulu, Oulu, Finland.
Abstract
BACKGROUND: Productivity costs result from loss of paid and unpaid work and replacements due to morbidity and mortality. They are usually assessed in health economic evaluations with human capital method (HCM) or friction cost method (FCM). The methodology for estimating lost productivity is an area of considerable debate. OBJECTIVE: To compare traditional and adjusted HCM and FCM productivity cost estimates among young stroke patients. METHODS: The Northern Finland Birth Cohort 1966 was followed until the age of 50 to identify all 339 stroke patients whose productivity costs were estimated with traditional, occupation-specific and adjusted HCM and FCM models by using detailed, national register-based data on care, disability, mortality, education, taxation and labour market. RESULTS: Compared to traditional HCM, taking into account occupational class, national unemployment rate, disability-free life expectancy and decline in work ability, the productivity cost estimate decreased by a third, from €255,960 to €166,050. When traditional FCM was adjusted for occupational class and national unemployment rate, the estimate more than doubled from €3,040 to €7,020. HCM was more sensitive to adjustments for discount rate and wage growth rate than FCM. CONCLUSIONS: This study highlights the importance of adjustments of HCM and FCM. Routine register-based data can be used for accurate productivity cost estimates of health shocks.
BACKGROUND: Productivity costs result from loss of paid and unpaid work and replacements due to morbidity and mortality. They are usually assessed in health economic evaluations with human capital method (HCM) or friction cost method (FCM). The methodology for estimating lost productivity is an area of considerable debate. OBJECTIVE: To compare traditional and adjusted HCM and FCM productivity cost estimates among young strokepatients. METHODS: The Northern Finland Birth Cohort 1966 was followed until the age of 50 to identify all 339 strokepatients whose productivity costs were estimated with traditional, occupation-specific and adjusted HCM and FCM models by using detailed, national register-based data on care, disability, mortality, education, taxation and labour market. RESULTS: Compared to traditional HCM, taking into account occupational class, national unemployment rate, disability-free life expectancy and decline in work ability, the productivity cost estimate decreased by a third, from €255,960 to €166,050. When traditional FCM was adjusted for occupational class and national unemployment rate, the estimate more than doubled from €3,040 to €7,020. HCM was more sensitive to adjustments for discount rate and wage growth rate than FCM. CONCLUSIONS: This study highlights the importance of adjustments of HCM and FCM. Routine register-based data can be used for accurate productivity cost estimates of health shocks.
Entities:
Keywords:
Cohort study; Friction cost method; Human capital method; Productivity costs; Stroke
Authors: Karen Barnett; Stewart W Mercer; Michael Norbury; Graham Watt; Sally Wyke; Bruce Guthrie Journal: Lancet Date: 2012-05-10 Impact factor: 79.321