One in three US adults are estimated to have cardiovascular disease (CVD), and many of these are of working age. CVD is among the leading causes of disability (including limitations in working) among the people with functional disabilities in the US. CVD has a substantial economic burden of $192 billion in direct and $120.5 billion in indirect costs, but these most recent estimates of indirect cost do not include lost productivity costs attributable to CVD among workers due to lack of adequate data. This gap in knowledge is important from patient, societal and medical perspective. For patients who are hospitalized for an acute cardiac event, return to work and work related outcomes (WRO) are important health outcomes. Helping patients return to work is an improvement in their functional health, leading to an increased sense of well-being and reduced individual and societal economic burden. Another reason to routinely measure and better understand work related outcomes is because the indirect costs of disease in terms of diminished work productivity and missed days of work are critical to fully appreciate the cost-benefit of treatment Nevertheless, measures of work productivity and related constructs are not readily available in many clinical studies. Estimation methods based on functional health measures that are often available can fill this gap in outcomes and help develop models of the inter-relationships of factors related to work productivity for CVD patients, which would guide efforts to improve these outcomes. Such models are currently lacking. We are proposing to use well-focused secondary data analyses and two conceptually and methodologically different approaches to estimate WRO from available self-reported functional health data. We will evaluate the performance of the two approaches in patients with CVD and compare results from the two methods in estimation precision. The approach that gives estimates closer to the truth will be applied to model factors associated with WRO for acute coronary syndrome patients in a data set without direct work productivity assessments. To achieve this goal we will use available data from 3 NIH-sponsored research grants. The successful completion of this project will result in practical and low cost approaches to estimating work productivity outcomes in studies with good patient-reported health data but no direct assessments of WRO. These methodological advances will also allow for a cost-effective exploration of factors related to WRO, which otherwise would be impossible. The study is an important step that will help accelerate a research program exploring health and other factors associated with WRO for patients with CVD, ultimately expanding understanding of the indirect costs of CVD and translating this knowledge into information about whether interventions are helping patients return to productive lives.
This project will develop practical low cost approaches to estimating work productivity outcomes in studies with good patient-reported health measures but no direct assessments of at work performance for cardiovascular patients. This information will be used to build models that would help in the development of interventions that facilitate the return of patients to productive lives.