Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England.
Public Health, Wessex Institute, University of Southampton, Southampton, England.
Eur J Health Econ. 2024 Sep;25(7):1095-1115. doi: 10.1007/s10198-023-01653-z. Epub 2023 Dec 26.
Around 2 million people in the UK suffer from Long COVID (LC). Of concern is the disease impact on productivity and informal care burden. This study aimed to quantify and value productivity losses and informal care receipt in a sample of LC patients in the UK.
The target population comprised LC patients referred to LC specialist clinics. The questionnaires included a health economics questionnaire (HEQ) measuring productivity impacts, informal care receipt and service utilisation, EQ-5D-5L, C19-YRS LC condition-specific measure, and sociodemographic and COVID-19 history variables. Outcomes were changes from the incident infection resulting in LC to the month preceding the survey in paid work status/h, work income, work performance and informal care receipt. The human capital approach valued productivity losses; the proxy goods method valued caregiving hours. The values were extrapolated nationally using published prevalence data. Multilevel regressions, nested by region, estimated associations between the outcomes and patient characteristics.
366 patients responded to HEQ (mean LC duration 449.9 days). 51.7% reduced paid work hours relative to the pre-infection period. Mean monthly work income declined by 24.5%. The average aggregate value of productivity loss since incident infection was £10,929 (95% bootstrap confidence interval £8,844-£13,014) and £5.7 billion (£3.8-£7.6 billion) extrapolated nationally. The corresponding values for informal caregiving were £8,726 (£6,247-£11,204) and £4.8 billion (£2.6-£7.0 billion). Multivariate analyses found significant associations between each outcome and health utility and C19-YRS subscale scores.
LC significantly impacts productivity losses and provision of informal care, exacerbated by high national prevalence of LC.
英国约有 200 万人患有长新冠(LC)。人们关注的是该病对生产力和非正式护理负担的影响。本研究旨在定量和评估英国 LC 患者样本中的生产力损失和非正式护理收入。
目标人群包括转介至 LC 专科诊所的 LC 患者。调查问卷包括一个健康经济学问卷(HEQ),用于衡量生产力影响、非正式护理收入和服务利用、EQ-5D-5L、C19-YRS LC 特定条件衡量标准以及社会人口统计学和 COVID-19 病史变量。结果是从导致 LC 的感染事件到调查前一个月的薪酬工作状态/小时、工作收入、工作绩效和非正式护理收入的变化。人力资本方法衡量生产力损失;代理商品法衡量护理时间。使用已发表的流行率数据在全国范围内进行外推。多层次回归,按地区嵌套,估计患者特征与结果之间的关联。
366 名患者对 HEQ 做出了回应(LC 持续时间的平均值为 449.9 天)。51.7%的人减少了相对于感染前的薪酬工作时间。每月工作收入平均下降 24.5%。自感染以来的生产力损失平均总价值为 10929 英镑(95% bootstrap 置信区间为 8844-13014 英镑),全国范围外推为 57 亿英镑(38-76 亿英镑)。非正式护理的相应价值为 8726 英镑(6247-11204 英镑)和 48 亿英镑(26-70 亿英镑)。多变量分析发现每个结果与健康效用和 C19-YRS 子量表评分之间存在显著关联。
LC 显著影响生产力损失和非正式护理的提供,由于 LC 的高全国流行率而加剧。