Productivity Costs of Cancer Mortality in the United States: 2000-2020
Productivity Costs of Cancer Mortality in the United States: 2000-2020
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DOI：
10.1093/jnci/djn384
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发表时间：
2008-12-17
影响因子：
10.3
通讯作者：
Brown, Martin L.
中科院分区：
文献类型：
--
作者：
Bradley, Cathy J.;Yabroff, K. Robin;Brown, Martin L.
预测降低癌症死亡率的经济效益的模型为将稀缺资源分配给效益最大的干预措施提供了关键信息。我们使用人力资本方法开发了模型，该方法依赖于收入作为生产力的衡量标准，以估计因癌症死亡而损失的生产力的价值。基础模型汇总了来自四个主要来源的特定年龄和性别的数据：1）美国人口普查局，2）1999-2003年美国死亡证明数据，3）1900-2000年伯克利死亡率数据库的队列生命表，以及4）劳工统计局当前人口调查。在一个包括养育和家务劳动成本的模型中，使用了美国国家人类活动模式调查和美国护理研究的数据。假设癌症死亡率下降1%，使用六种癌症进行敏感性分析。然后估计了2000- 2020年就业个人放弃的收入和非正式就业放弃的收入的价值。在基础模型中，2000年癌症死亡率造成的年生产力成本约为1158亿美元; 2020年的预测值为1476亿美元。肺癌死亡占生产力成本的27%以上。肺癌、结直肠癌、乳腺癌、白血病、胰腺癌和脑癌死亡率每年降低1%，生产成本每年降低8.14亿美元。包括由于生育和家庭活动造成的估算收入损失，2000年基础模型总生产力成本增加到2324亿美元，2020年增加到3080亿美元。针对高发癌症和/或发生在年轻工作年龄个体中的癌症的计划投资可能会最大限度地减少社会生产力损失。
A model that predicts the economic benefit of reduced cancer mortality provides critical information for allocating scarce resources to the interventions with the greatest benefits.We developed models using the human capital approach, which relies on earnings as a measure of productivity, to estimate the value of productivity lost as a result of cancer mortality. The base model aggregated age- and sex-specific data from four primary sources: 1) the US Bureau of the Census, 2) US death certificate data for 1999-2003, 3) cohort life tables from the Berkeley Mortality Database for 1900-2000, and 4) the Bureau of Labor Statistics Current Population Survey. In a model that included costs of caregiving and household work, data from the National Human Activity Pattern Survey and the Caregiving in the U.S. study were used. Sensitivity analyses were performed using six types of cancer assuming a 1% decline in cancer mortality rates. The values of forgone earnings for employed individuals and imputed forgone earnings for informal caregiving were then estimated for the years 2000-2020.The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020.Investments in programs that target the cancers with high incidence and/or cancers that occur in younger, working-age individuals are likely to yield the greatest reductions in productivity losses to society.