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.

中文翻译：

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通过人力资本和摩擦成本方法调整中风的生产力成本：1966 年芬兰北部出生队列研究

背景

生产力成本是由于发病率和死亡率导致的有偿和无偿工作的损失和替代。它们通常在健康经济评估中使用人力资本法 (HCM) 或摩擦成本法 (FCM) 进行评估。估计生产力损失的方法是一个颇有争议的领域。

客观的

比较年轻中风患者的传统和调整后的 HCM 和 FCM 生产力成本估计。

方法

芬兰北部出生队列 1966 年被追踪到 50 岁，以确定所有 339 名中风患者，这些患者的生产力成本是通过传统的、职业特定的和调整后的 HCM 和 FCM 模型通过使用详细的、基于国家登记的护理、残疾、死亡率、教育、税收和劳动力市场。

结果

与传统的 HCM 相比，考虑到职业等级、全国失业率、无残疾预期寿命和工作能力下降，生产力成本估计减少了三分之一，从 255,960 欧元降至 166,050 欧元。当传统的 FCM 根据职业类别和国家失业率进行调整时，估计值从 3,040 欧元增加到 7,020 欧元，增加了一倍多。HCM 对贴现率和工资增长率的调整比 FCM 更敏感。

结论

本研究强调了调整 HCM 和 FCM 的重要性。基于常规登记的数据可用于准确估计健康冲击的生产力成本。