Influence of Rheumatoid Arthritis on Employment, Function, and Productivity in a Nationally Representative Sample in the United States

Objective. The Medical Expenditure Panel Survey (MEPS) was used to estimate the national influence of rheumatoid arthritis (RA) on employment, limitations in work or housework, inability to work or do housework, missed work days, days spent sick in bed, and annual wages. Methods. MEPS is a nationally representative survey of the US population. Multiple logistic, negative binomial, and Heckman selection regression methods were used, controlling for age, sex, race, ethnicity, smoking status, income, education, and chronic comorbidity. RA was identified using International Classification of Diseases-9 code 714. Results. In unadjusted descriptive statistics, individuals with RA were older, had more chronic conditions, missed more work days, spent more days sick in bed, had lower employment rates, had higher rates of limitations and inability to work, and received disability benefits at higher rates. After adjustment, multiple regression analyses showed individuals with RA were 53% less likely to be employed [OR 0.47, 95% CI 0.34-0.65], 3.3 times more likely to have limitations in work or housework (95% CI 2.35-4.64), 2.3 times more likely to be unable to work or do housework (95% CI 1.55-3.53), and spent 3.6 times as many days sick in bed as those without RA (95% CI 2.32-5.53). RA was associated with an expected loss of $8957 in annual earnings (95% CI $1881-$15,937). There was no statistically significant difference in missed work days or the level of wages. Conclusion. In the most recent available national data for adults, RA was associated with reductions in employment, productivity, and function. (First Release Jan 15 2010; J Rheumatol 2010;37:544-9; doi:10.3899/jrheum.081306)