A168 Costs of Missed Work Among People With Inflammatory Bowel Disease: A Cross-Sectional Population-Representative Study

Abstract

Background The relapsing and remitting symptoms experienced by people with inflammatory bowel disease (IBD), including abdominal pain and diarrhea, may impact their employability and workplace productivity. Purpose Report the impact of IBD on missed work and its associated costs using population-representative data with the goal of understanding the population-level indirect costs of IBD in Canada. Method We used the 2010 and 2014 waves of the Canadian Community Health Survey (CCHS) to compare missed work and its associated costs among survey respondents aged 20 to 64 years with physician-diagnosed IBD compared to those without IBD. Students and those with non-IBD bowel disorders were excluded. The cost of missed work was derived from reported annual income and the number of workdays missed. Survey weights were used for descriptive statistics. Poisson regression modified for binary outcomes was used to compare employment within the past 3 months among those with and without IBD. Heckman models (two-stage models accounting for the likelihood of being employed) were used to compare the number of days missed and the cost of missed work in the two groups. Models were adjusted for age, sex, education, marital status, immigration status, visible minority status, number of non-IBD chronic conditions, and mood or anxiety disorder. All costs were inflation-adjusted to 2022 Canadian dollars. Result(s) Among 67,907 eligible respondents, 810 (weighted 1.0%) had IBD. Employment in the last 3 months was reported among 70% of people with IBD compared to 80% of people without IBD (RR 0.92, 95% CI 0.88 to 0.96). Among those employed in the prior 3 months, employed people with IBD missed an average of 1.6 (SD 4.4) days of work compared to 1.0 (SD 3.5) days missed among those without IBD, corresponding to $415 (SD 1315) in lost wages among those with IBD and $235 (SD 932) among those without IBD. Accounting for the higher rates of unemployment in those with IBD using Heckman models, people with IBD missed an additional 1.1 days (95% CI 0.7 to 1.5) of work and lost an additional $270 (95% CI 163 to 377) in income over 3 months. Extrapolating to the estimated 184,460 employed Canadians with IBD, the attributable indirect cost of missed work due to IBD is nearly $200 million annually. Conclusion(s) The economic burden of IBD resulting from missed work is substantial. Since IBD is often diagnosed during adolescence and early adulthood, employability and productivity are important long-term patient-centered outcomes. Novel interventions that could mitigate these attendant effects of IBD are urgently needed to improve patient outcomes. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

The 2023 Impact of Inflammatory Bowel Disease in Canada: Indirect (Individual and Societal) and Direct Out-of-Pocket Costs

“…Costs related to intermittent absences can directly impact an individual’s earnings when they do not have paid sick days or impact employers through costs related to replacing an employee or lost productivity due to an employee’s absence. Among respondents to the Canadian Community Health Survey with IBD, those who were employed missed an average of 1.6 (SD: 4.4) days of work over a three-month period; people without IBD missed an average of 1.0 (SD: 3.5) days of work ( 2 ). This equated to an additional 1.1 days (95% CI: 0.7, 1.5) of work missed among people living with IBD at a cost of $270 (95% CI: 163, 377) over three months, after accounting for differences in the probability of employment between people with and without IBD ( 2 ).…”

“…Among respondents to the Canadian Community Health Survey with IBD, those who were employed missed an average of 1.6 (SD: 4.4) days of work over a three-month period; people without IBD missed an average of 1.0 (SD: 3.5) days of work ( 2 ). This equated to an additional 1.1 days (95% CI: 0.7, 1.5) of work missed among people living with IBD at a cost of $270 (95% CI: 163, 377) over three months, after accounting for differences in the probability of employment between people with and without IBD ( 2 ). Extrapolating to a full year, people with IBD miss an additional 4.4 days at a cost of $1080 every year compared to people without IBD.…”

“…Extrapolating costs estimated in the Finnish study ( 10 ) to the Canadian context (adjusting for inflation and purchasing power parities) ( 12 ), the total cost of presenteeism among people with IBD is estimated to be $812 (CAD) per person per year, or more than $122 million annually among the 150,775 employed Canadians with IBD ( 2 ).…”

“…Since the 2018 Impact of IBD in Canada report ( 20 ), no additional studies have described the costs of premature retirement or mortality in Canada. Based on data from the Canadian Community Health Survey, people living with IBD are significantly less likely than those without IBD to be employed in the previous three months (70% vs. 80%; adjusted relative risk: 0.92; 95% CI: 0.88, 0.96) ( 2 ). With an additional 10% unemployment among people with IBD, we expect 23,124 people with IBD of working age (18–64) to be unemployed for reasons related to their IBD ( 2 ).…”

“…Based on data from the Canadian Community Health Survey, people living with IBD are significantly less likely than those without IBD to be employed in the previous three months (70% vs. 80%; adjusted relative risk: 0.92; 95% CI: 0.88, 0.96) ( 2 ). With an additional 10% unemployment among people with IBD, we expect 23,124 people with IBD of working age (18–64) to be unemployed for reasons related to their IBD ( 2 ). With a mean employment income of $52,928 ( 21 ), the attributable indirect costs of unemployment among individuals living with IBD equate to $1.23 billion.…”