The socio-economic impact of work disability due to inflammatory bowel disease in Brazil

Eur J Health Econ. 2018 Apr;19(3):463-470. doi: 10.1007/s10198-017-0896-4. Epub 2017 May 18.

Abstract

Background: Inflammatory bowel disease (IBD) might have economic and social impacts in Brazil, where its prevalence has increased recently. This study aimed to assess disability due to IBD in the Brazilian population and demographic factors potentially associated with absence from work.

Methods: Analysis was performed using the computerized Single System of Social Security Benefits Information, with a cross-check for aid pension and disability retirement, for Crohn's disease (CD) and ulcerative colitis (UC). Additional data were obtained from the platform, including the average values, benefit duration, age, gender and region of the country.

Results: Temporary disability occurred more frequently with UC, whereas permanent disability was more frequent with CD. Temporary disability affected more younger patients with CD than patients with UC. Temporary work absences due to UC and CD were greater in the South, and the lowest absence rates due to CD were noted in the North and Northeast. Absence from work was longer (extending for nearly a year) in patients with CD compared to those with UC. The rates of temporary and permanent disability were greater among women. Permanent disability rates were higher in the South (UC) and Southeast (CD). The value of benefits paid for IBD represented approximately 1% of all social security benefits. The benefits paid for CD were higher than for UC, whereas both tended to decrease from 2010 to 2014.

Conclusions: In Brazil, IBD frequently causes disability for prolonged periods and contributes to early retirement. Reduction trends may reflect improvements in access to health care and medication. Vocational rehabilitation programs may positively impact social security and the patients' quality of life.

Keywords: Crohn’s disease; Indirect costs; Inflammatory bowel diseases; Productivity loss; Ulcerative colitis; Work disability.

MeSH terms

  • Adult
  • Brazil
  • Colitis, Ulcerative
  • Crohn Disease
  • Disabled Persons*
  • Female
  • Health Care Costs*
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / economics*
  • Inflammatory Bowel Diseases / rehabilitation
  • Male
  • Quality of Life