This page contains a Flash digital edition of a book.
INDIRECT COSTS


Instead, it is more reliable to compare overall rates of employment in people with IBD to rates in the general population. The assumption is that any difference in employment rates can be due to IBD. There are likely additional costs from people who reduce their work hours, but this has not been measured in any survey.


Impact on Employment


There were two studies in Canada, two in Australia, two in Europe, and one in the United States which looked at employment rates in people with IBD. A meta-analysis of these seven studies found that IBD was associated with a 13% reduction in the probability that a person will be employed. In other words, since the Canadian general population has a labour participation rate of 80%, then an IBD population would have a labour participation rate of (80% - 13% = 67%). Each year, this would correspond to $1.4 billion for 30,000 Canadians with IBD not able to work.


Two Canadian studies had inconsistent findings. The first was conducted in the province of Manitoba, using people who were definitely identified as having IBD based on repeated health care system contacts due to IBD.80


Their employment status was compared to that of


the general Manitoba population. They found that after diagnosis, people with IBD gradually withdrew from work and were more likely to be unemployed, disabled or retired. Compared to the general population, people with IBD had a statistically significant reduction of about 9.3% in employment rate.


In a different approach, researchers asked Canadians who participated in the National Population Health Survey whether they had IBD. The labour participation rates were compared between people who reported IBD and those who did not. This approach can be limited by recall and the wording of the question, that is, whether people accurately report whether they have IBD. In fact, 1.7% of the population reported having IBD in the survey. This is much higher than expected (0.6%) suggesting that some people reported having IBD when in fact they did not. The results of this study were that non-participation in the workforce due to IBD was found to be only 2.9%.87


By contrast, an American general population health survey was done by the


same researchers who did the Canadian survey. In this survey, the percentage of people who reported IBD was 0.4% of the population – pretty much what would be expected, given the prevalence of IBD. In this survey, the excess rate of non-participation was 12.3% - very close to the meta-analysis finding.88


The main difference between the surveys was that too many


people in the Canadian survey described themselves as having IBD when they likely did not and these individuals had a rate of labour participation similar to the national average.


New research on disability rates in Norway found that ten years after diagnosis, 19% of people with IBD received a disability pension.89


The disability rate was similar for both CD


and UC. People under 40 were at highest risk for workplace disability compared to the general population. This research supports that society incurs ongoing costs of IBD; as people withdraw from the work force and are replaced by other workers, employers continue to bear the burden of IBD disability.


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 57


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96