Format

Send to

Choose Destination
See comment in PubMed Commons below
J Clin Endocrinol Metab. 2013 Jan;98(1):145-52. doi: 10.1210/jc.2012-3119. Epub 2012 Nov 26.

Public health relevance of Graves' orbitopathy.

Author information

1
Department of Ophthalmology, Johannes Gutenberg University Medical Centre, 55101 Mainz, Germany.

Abstract

CONTEXT:

Disfiguring proptosis and functional impairment in patients with Graves' orbitopathy (GO) may lead to impaired earning capacity and to considerable indirect/direct costs.

OBJECTIVE:

The aim of the study was to investigate the public health relevance of GO.

DESIGN AND SETTING:

This cross-sectional study was performed between 2005 and 2009 at a multidisciplinary university orbital center.

PATIENTS:

A total of 310 unselected patients with GO of various degrees of severity and activity participated in the study.

INTERVENTIONS:

We conducted an observational study.

MAIN OUTCOME MEASURES:

We measured work disability and sick leave as well as the resulting indirect/direct costs of GO-specific therapies.

RESULTS:

Of 215 employed patients, 47 (21.9%) were temporarily work disabled, and 12 (5.6%) were permanently work disabled. Five (2.3%) had lost their jobs, and nine (4.2%) had retired early. The mean duration of sick leave was 22.3 d/yr. Compared with the German average of 11.6 d/yr, 32 (15%) patients had taken longer sick leaves. The duration of sick leave correlated with the disease severity (P = 0.015), and work disability correlated with diplopia (P < 0.001). Multivariable analysis identified diplopia as the principal predictor for work disability (odds ratio, 1.7; P < 0.001). The average costs due to sick leave and work disability ranged between 3,301€ (4,153$) and 6,683€ (8,407$) per patient per year. Direct costs were 388 ± 56€ (488 ± 70$) per patient per year and per year were higher in sight-threatening GO (1,185 ± 2,569€; 1,491 ± 3,232$) than in moderate-to-severe (373 ± 896€; 469 ± 1,127$; P = 0.013) or in mild GO (332 ± 857€; 418 ± 1,078$; P = 0.016). Total indirect costs ranged between 3,318€ (4,174$) (friction cost method) and 6,738€ (8,476$) (human capital approach). Work impairment as well as direct and indirect costs of GO significantly correlated with the scores of the internationally standardized and specific GO quality-of-life questionnaire.

CONCLUSIONS:

Productivity loss and a prolonged therapy for GO incur great indirect and direct costs.

PMID:
23185037
DOI:
10.1210/jc.2012-3119
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center