Sick Leave and Disability Pension in Prevalent Patients With Crohn's Disease.

Åsa H Everhov, Hamed Khalili, Johan Askling, Pär Myrelid, Jonas F Ludvigsson, Jonas Halfvarson, Caroline Nordenvall, Jonas Söderling, Ola Olén, Martin Neovius

Journal: Journal of Crohn's & colitis 2019;12(12):1418-1428

PMID: 30165593

Abstract

BACKGROUND AND AIMS

Crohn's disease may affect the ability to work and lead to permanent disability. We aimed to investigate work loss in prevalent patients.

METHODS

We identified patients with Crohn's disease and general population comparators matched by sex, birth year, healthcare region and education. We assessed days of sick leave and disability pension retrieved from the Swedish Social Insurance Agency and estimated the absolute and relative risk of receiving disability pension [minimum 25% work impairment].

RESULTS

In 2014, the 20638 Crohn's disease patients [median age 44 years] had more than twice as many mean lost workdays [disability pension: 44; sick leave: 19] as the 102038 comparators [disability pension: 20; sick leave: 8], mean difference 35 days [95% confidence interval 33-37]. However, the majority had no lost workdays [68% of patients and 85% of comparators]. The proportion of patients receiving disability pension was 15% (6.5% in the comparators, risk ratio 2.34 [2.25-2.43]) and was higher in all subgroups, especially in female patients [28% vs 13% in the comparators], in those with ≤9 years of education [41% vs 23%] and in ages 60-64 years [46% vs 25%]. The relative risk of disability pension within the patient cohort [adjusted for age, sex, region and education] was higher in patients with complicated disease behaviour, extraintestinal manifestations, need of surgery or treatment with biologics. The differences between patients and comparators remained when comparing other calendar years [2006-2013].

CONCLUSION

Work loss was found in approximately one-third of patients. The mean number of lost workdays was twice as high as in the comparators.

Address: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Division of Surgery, Department of Clinical and Experimental Medicine, Faulty of Health Sciences, Linköping University and Department of Surgery, County Council of Östergötland Linköping, Sweden.; Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.; Center for Digestive Disease, Division of Coloproctology, Karolinska University Hospital, Stockholm, Sweden.; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Department of Pediatric gastroenterology and Nutrition, Sachs' Children and Youth Hospital, Stockholm, Sweden.
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