美国在职成人中哮喘与旷工的关系:来自2008年医疗费用调查小组的研究结果
2012/10/11
摘要
目的:本研究旨在评价美国在职成人中哮喘状态与旷工及旷工时间的关系。
方法:本试验为横断面研究,采用的数据来自于2008年医疗费用调查小组研究(MEPS)。在职的回复者年龄在18-55岁间。采用由两部分组成的模型,评价哮喘状态(回复者是否患有哮喘)与旷工及旷工时间的关系。多变量logistic回归作为第一个模型,用于评价由于哮喘影响,在观察期内至少一次旷工的可能性;多变量负二项回归作为第二个模型,在至少存在一次旷工的回复者中,评价每次旷工时间与哮喘状态之间的关系。社会人口统计学、社会经济、雇佣相关、健康状态和共患病等指标作为协变量入选每个模型。
结果:12161名回复者中,8.2%主诉存在哮喘。如果以此比例计算,就美国来说, 2008年有约1040万在职成人为哮喘患者。二项分析中,与无哮喘主诉者相比,在职的哮喘患者更有可能主诉至少一次旷工(26.2% vs. 16.2%, p < 0.01)。在对一些共患慢性病和其他协变量进行校正后,哮喘者与旷工者之间无显著差异(OR= 1.31, 95% CI =0.99-1.72;RR= 1.25, 95% CI = 0.91-1.72)。
结论:基于共患病指标和感知的健康状态(而非单独哮喘)来检测的总体疾病负担,与在职成人的旷工及旷工天数相关。对于健康服务研究者,在研究一般转归(如:旷工)和具体情况(如:哮喘)时,应该考虑总体的疾病负担。
(苏楠 审校)
J Asthma. 2012 Sep;49(7):757-764.
The Association between Asthma and Absenteeism among Working Adults in the United States: Results from the 2008 Medical Expenditure Panel Survey.
Wu CH, Erickson SR.
Source
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Caroline , Chapel Hill, NC , USA.
Abstract
OBJECTIVE:The purpose of this study was to evaluate the association between asthma status and the occurrence and length of work absences among the US working adults. METHODS:A cross-sectional study was conducted using the 2008 Medical Expenditure Panel Survey (MEPS). Employed respondents between ages 18 and 55 years were included. The association between asthma status (whether respondents have asthma or not) and occurrence of absences and the length of time per absence was evaluated using a two-part model. A multivariate logistic regression as the first part of the model was to estimate the probability of being absent from work at least once during the observation period as a function of asthma status. A multivariate negative binomial regression as the second part of the model was used to assess whether the length of each absence from work was associated with asthma status among respondents who reported at least one absence from work. Sociodemographic, socioeconomic, employment-related, health status, and comorbidity variables were included in each model as covariates.
RESULTS:Of 12,161 respondents, 8.2% reported having asthma, which accounted for 10.4 million working adults in the United States in 2008. Employed adults with asthma were more likely to report having at least one absence from work compared to those without asthma in bivariate analyses (26.2% vs. 16.2%, p < .01). After adjusting for the number of comorbid chronic conditions and other covariates, there was no significant difference between having asthma and absenteeism among respondents (odds ratio (OR) = 1.31, 95% confidence interval (CI) = 0.99-1.72, rate ratio (RR) = 1.25, 95% CI = 0.91-1.72).
CONCLUSIONS: Overall burden of illness as measured by comorbidity indices and perceived health status, but not asthma alone, contributes to absenteeism as well as the number of days off during each occurrence among employed people. It is important for health services researchers to consider overall burden of illness when examining the association between a general outcome such as absence from work and specific conditions such as asthma.
J Asthma. 2012 Sep;49(7):757-64.
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