Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120
Presentation
The Economic Burden of Occupational Skin Disease in the US
Background: Occupational skin disease (OSD) can be a significant burden on employers and ultimately society. Calculating the cost of occupational skin disease has proven difficult. Primary data are sparse for this illness. Generally, surveillance is not directed at skin diseases. Also co-morbidities and often clinical diagnoses are not obtained or may be misclassified. This study uses the cost of illness method to estimate the burden of OSD in the US. Results are presented for all skin disorders, irritant contact dermatitis (IrCD), and all skin disorders excluding IrCD for the entire US population and for the working population - those aged 16 to 65 - using the ICD-9-CM definitions. The 2004 MEPS of AHQR and the ASOII of the BLS were used. Objectives: The goal here was to determine the economic burden of OSD in the working population, aged 16 to 65, by industry classifications.
Methods: The cost of illness method was used. Direct and indirect health care costs are combined to ascertain the economic burden. Direct costs include the costs of physician's office visits, outpatient hospital visits, emergency room visits, inpatient hospital costs, and prescription drug costs. Indirect costs are calculated from the dollar value of days of work lost because of skin diseases of in caring for a family member with skin disease. Industries are classified into seven groups similar to the National Occupational Research Sector breakdowns of the National Institute for Occupational Safety and Health. Additional analysis presents the breakdown of health care costs by age, gender, and occupation groups.
Results: The economic burden of skin disease for workers in the US is large, estimated at approximately $13.1 billion (b) in 2004. This includes $9.6b (73.2%) in health care costs and $3.5b (26.2%) in productivity losses. Health care costs include $7.9b (83.9%) in ambulatory care costs ? office-based (96.6%), out-patient (0.7%), and emergency room visits (2.7%) of ambulatory costs; $0.5b (5.1%) in hospital inpatient charges; $0.4b(4.3%) in prescription drug costs; $4.3b(6.7%) in home health care visits. Indirect costs attributable to lost workdays amount to about one-fourth of this economic burden. The all services sector and the wholesale and retail trade sector, the two largest employment sectors, have the largest number of direct cost expenditures and productivity losses based on reliable sample numbers.
Conclusions: The ascertainment of the economic burden of occupational skin disease in the US is high, especially when compare to two other more common illnesses - asthma and pneumonia and influenza - neither of which include any mortality information. But, this estimate is likely to be higher. The determination presented here underestimates the true economic burden. It uses information from those reporting health care visits and the types and costs of those visits. It excludes OTC medicines, it does not include cost of time spent to utilize health care, and it does not try to account for the number who self-medicate. Additionally, it also does not adjust estimates for any reduction in one's quality of life. Improved surveillance will be a key factor in improving these estimates.