HEALTH COSTS OF OCCUPATIONAL-DISEASE IN NEW-YORK STATE
HEALTH COSTS OF OCCUPATIONAL-DISEASE IN NEW-YORK STATE
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DOI：
10.1002/ajim.4700160409
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发表时间：
1989-01-01
影响因子：
3.5
通讯作者：
LANDRIGAN, PJ
中科院分区：
文献类型：
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作者：
FAHS, MC;MARKOWITZ, SB;LANDRIGAN, PJ
职业病和死亡是代价高昂的事件。他们负责：1)直接医疗费用；2)因生产损失、机会丧失和投资减少而产生的间接成本；3)非经济成本，包括痛苦和折磨、事业中断和家庭破裂。为了对纽约州职业病的总成本进行部分估计，我们研究了四类疾病：职业性癌症、慢性呼吸系统疾病和尘肺病、脑血管和心血管疾病以及终末期肾衰竭。我们根据人力资本方法对这些疾病的成本进行了部分估计。利用现有的最佳测量方法，包括发病率和流行率统计数据、死亡率记录和各种财务数据，我们采用人力资本方法的两种成本会计技术，发病率法和流行率法。我们的分析显示，这四种职业病每年给纽约造成的损失超过6亿美元。这一数字是实用但保守的，对纽约州职业病总经济成本相对规模的下限估计。这些费用中最大的比例（80%）是职业性癌症造成的。卫生保健系统未能认识到职业病的成本，就无法认识到预防这些疾病所带来的经济效益。人们希望这项研究将促进流行病学和经济学方法的进步，以解决这一重要的测量问题。
Occupational diseases and deaths are costly events. They are responsible for: 1) direct medical costs; 2) indirect costs, resulting from lost production, foregone opportunities, and diminished investment; and 3) non‐economic costs, including pain and suffering, disrupted careers, and devastated families. To develop a partial estimate of the total costs of occupational disease in New York State, we have examined four categories of illness: occupational cancer, chronic respiratory disease and the pneumoconioses, cerebrovascular and cardiovascular disease, and end‐stage renal failure. We base our partial estimate on the human capital approach to the costs of these illnesses. Using the best measures available, including both incidence and prevalence statistics, mortality records, and a variety of financial data, we employ two cost accounting techniques of the human capital approach, the incidence method, and the prevalence method. Our analysis shows that these four occupational illnesses are costing New York over 600 million per year. This figure is a pragmatic but conservative, lower‐bound estimate of the relative magnitude of total economic costs of occupational disease in New York State. The largest proportion of these costs (80%) is due to occupational cancer. The failure of the health care system to recognize the costs of occupational disease precludes recognition of the economic benefits which would result from preventing these illnesses. This study, it is hoped, will stimulate advances in epidemiological and economic approaches to resolve this important measurement problem.