The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work

Objective: The objective of this study was to assess the cost attributable to lost productivity from arthritis and the association between the degree of loss and demographic, disease-related, occupational, and psychosocial variables for people. Methods: In a prospective study, 383 employed individuals with arthritis were recruited from southwestern Ontario, Canada. Respondents completed structured questionnaires assessing demographic, disease-related, workplace, and psychosocial variables as well as employment-related transitions at 2 time points 18 months apart. Indirect costs resulting from arthritis-related absences, reduced performance, decreased work hours, job change, and work disability were estimated. A proportional odds model was used to assess the impact of the various variables on lost productivity. Results: The average cost attributable to arthritis was CAN $11,553 ($CAN = 0.75 $US) per person per year. The largest component of the loss was the result of reduced performance at work, which accounted for 41% ($4724) of the total loss. This was followed by wage loss resulting from stopping working or changing jobs, which comprised 37% ($4309) of the total. Another 12% ($1398) and 10% ($1121) of the loss were the result of the decrease in hours of work and absenteeism, respectively. Four variables were associated with the productivity loss: greater symptom severity (odds ratio [OR] = 1.11), low or medium control over the work schedule (OR = 0.55 and 0.60, respectively), greater workspace limitation (OR = 1.10), and higher depression (OR = 1.04). Conclusions: Indirect arthritis-related costs are substantial. Our results show that not only the disease itself, but also psychosocial and work-related factors affect the magnitude of the costs.