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

Med Care. 2006 Apr;44(4):304-10. doi: 10.1097/01.mlr.0000204257.25875.04.


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 Dollars 11,553(Dollars CAN = 0.75 Dollars US) per person per year. The largest component of the loss was the result of reduced performance at work, which accounted for 41% (Dollars 4724) of the total loss. This was followed by wage loss resulting from stopping working or changing jobs, which comprised 37% (Dollars 4309) of the total. Another 12% (Dollars 1398) and 10% (Dollars 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Adult
  • Arthritis, Rheumatoid / economics*
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / physiopathology
  • Career Mobility
  • Cost of Illness*
  • Efficiency
  • Employment / economics
  • Employment / psychology
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Expenditures / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / economics*
  • Occupational Diseases / epidemiology
  • Occupational Diseases / physiopathology
  • Ontario / epidemiology
  • Prospective Studies
  • Severity of Illness Index
  • Sick Leave / economics*
  • Sick Leave / statistics & numerical data
  • Surveys and Questionnaires
  • Work Capacity Evaluation