TY - JOUR
T1 - Estimated loss of lifetime employment duration for patients undergoing maintenance dialysis in Taiwan
AU - Chang, Yu Tzu
AU - Wang, Fuhmei
AU - Huang, Wen Yen
AU - Hsiao, Hsuan
AU - Wang, Jung Der
AU - Lin, Chang Ching
N1 - Funding Information:
Y.-T. Chang reports honoraria from Baxter, Boehringer Ingelheim, Eli Lilly, Merck Sharp and Dohme, and Novo Nordisk. H. Hsiao reports employment with National Cheng Kung University. W.-Y. Huang reports employment with Taiwan National Cheng Kung University. C.-C. Lin reports employment with National Cheng Kung University and research funding from The Ministry of Science and Technology in Taiwan (grant numbers MOST 107-2410-H-006-015, MOST 108-2410-H-006-009, MOST 108-2627-M-006-001, and MOST 109-2410-H-006-081). F. Wang reports employment with
Funding Information:
The present research was supported by Taiwan Ministry of Science and Technology grantMOST108-2627-M006-001andbygrantNCKUH-11002022 from National Cheng-Kung University Hospital.
Publisher Copyright:
© 2021 by the American Society of Nephrology.
PY - 2021/5/8
Y1 - 2021/5/8
N2 - Background and objectives An accurate estimate of the loss of lifetime employment duration resulting from kidney failure can facilitate comprehensive evaluation of societal financial burdens. Design, setting, participants, & measurements All patients undergoing incident dialysis in Taiwan during 2000–2017 were identified using the National Health Insurance Research Database. The corresponding age-, sex-, and calendar year-matched general population served as the referents. The survival functions andthe employment states of the index cohort (patients on dialysis) and their referents for each age strata were first calculated, and then extrapolated until age 65 years, where the sum of the product of the survival function and the employment states was the lifetime employment duration. The difference in lifetime employment duration between the index and referent cohort was the loss of lifetime employment duration. Extrapolation of survival function and relative employment-to-population ratios were estimated by the restricted cubic spline models and the quadratic/linear models, respectively. Results A total of 83,358 patients with kidney failure were identified. Men had a higher rate of employment than women in each age strata. The expected loss of lifetime employment duration for men with kidney failure was 11.8, 7.6, 5.7, 3.8, 2.3, 1.0, and 0.2 years for those aged 25–34, 35–40, 41–45, 46–50, 51–55, 56–60, and 61–64 years, respectively; and the corresponding data for women was 10.5, 10.1, 7.9, 5.6, 3.3, 1.5, and 0.3 years, respectively. The values for loss of lifetime employment duration divided by loss of life expectancy were all >70% for women and >88% for men across the different age strata. The sensitivity analyses indicated that the results were robust. Conclusions The loss of lifetime employment duration in patients undergoing dialysis mainly originates from loss of life expectancy.
AB - Background and objectives An accurate estimate of the loss of lifetime employment duration resulting from kidney failure can facilitate comprehensive evaluation of societal financial burdens. Design, setting, participants, & measurements All patients undergoing incident dialysis in Taiwan during 2000–2017 were identified using the National Health Insurance Research Database. The corresponding age-, sex-, and calendar year-matched general population served as the referents. The survival functions andthe employment states of the index cohort (patients on dialysis) and their referents for each age strata were first calculated, and then extrapolated until age 65 years, where the sum of the product of the survival function and the employment states was the lifetime employment duration. The difference in lifetime employment duration between the index and referent cohort was the loss of lifetime employment duration. Extrapolation of survival function and relative employment-to-population ratios were estimated by the restricted cubic spline models and the quadratic/linear models, respectively. Results A total of 83,358 patients with kidney failure were identified. Men had a higher rate of employment than women in each age strata. The expected loss of lifetime employment duration for men with kidney failure was 11.8, 7.6, 5.7, 3.8, 2.3, 1.0, and 0.2 years for those aged 25–34, 35–40, 41–45, 46–50, 51–55, 56–60, and 61–64 years, respectively; and the corresponding data for women was 10.5, 10.1, 7.9, 5.6, 3.3, 1.5, and 0.3 years, respectively. The values for loss of lifetime employment duration divided by loss of life expectancy were all >70% for women and >88% for men across the different age strata. The sensitivity analyses indicated that the results were robust. Conclusions The loss of lifetime employment duration in patients undergoing dialysis mainly originates from loss of life expectancy.
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U2 - 10.2215/CJN.13480820
DO - 10.2215/CJN.13480820
M3 - Article
C2 - 33858826
AN - SCOPUS:85106552164
SN - 1555-9041
VL - 16
SP - 746
EP - 756
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 5
ER -