Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Productivity costs of nonviral sexually transmissible infections among patients who miss work to seek medical care: evidence from claims data

Kwame Owusu-Edusei Jr A B , TaNisha M. Roby A , Harrell W. Chesson A and Thomas L. Gift A
+ Author Affiliations
- Author Affiliations

A Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road M/S E-80, Atlanta, GA 30333, USA.

B Corresponding author. Email: kowusuedusei@cdc.gov

Sexual Health 10(5) 434-437 https://doi.org/10.1071/SH13021
Submitted: 12 February 2013  Accepted: 18 June 2013   Published: 30 August 2013

Abstract

Background: Productivity losses can arise when employees miss work to seek care for sexually transmissible infections (STIs). We estimated the average productivity loss per acute case of four nonviral STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. Methods: We extracted outpatient claims from 2001–2005 MarketScan databases using International Classification Disease ver. 9 (ICD-9) codes. We linked claims with their absence records in the Health and Productivity Management database by matching enrolee identifiers and the service dates from the claims such that our final data included only those who were absent because they were sick and were diagnosed with an STI on the day of their visit. To ensure that the visit was for the STIs being examined, we restricted the criteria to records with the specified ICD-9 codes only, excluding claims with other codes. We estimated the average number of hours absent and multiplied it by the mean hourly wage rate including benefits ($29.72 in 2011 United States dollars) to estimate the average productivity loss per case. Results: The average productivity losses per case were: $262 for chlamydia, $197 for gonorrhoea, $419 for syphilis and $289 for trichomoniasis. There were no significant differences between males and females. Conclusions: Among those who take sick leave to seek care, productivity losses associated with treating nonviral STIs may be higher than their estimated direct medical costs. These productivity cost estimates can help to quantify the overall STI burden, and inform cost-effectiveness analyses of prevention and control efforts.

Additional keywords: absence from work, chlamydia, gonorrhoea, syphilis, trichomoniasis.


References

[1]  Haddix AC, Teusch SM, Corso PS, eds. Prevention effectiveness: a guide to decision analysis and economic evaluation. 2nd ed. New York: Oxford University Press; 2003.

[2]  Owusu-Edusei K Jr., Chesson HW, Gift TL, Tao G, Mahajan R, et al Owusu-Edusei K Jr., Chesson HW, Gift TL, Tao G, Mahajan R, et al The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis 2013; 40 197–201.
The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008.Crossref | GoogleScholarGoogle Scholar |

[3]  Johns G. Attendance dynamics at work: the antecedents and correlates of presenteeism, absenteeism, and productivity loss. J Occup Health Psychol 2011; 16 483–500.
Attendance dynamics at work: the antecedents and correlates of presenteeism, absenteeism, and productivity loss.Crossref | GoogleScholarGoogle Scholar |

[4]  Goetzel RZ, Carls GS, Wang S, Kelly E, Mauceri E, Columbus D, et al The relationship between modifiable health risk factors and medical expenditures, absenteeism, short-term disability, and presenteeism among employees at Novartis. J Occup Environ Med 2009; 51 487–99.
The relationship between modifiable health risk factors and medical expenditures, absenteeism, short-term disability, and presenteeism among employees at Novartis.Crossref | GoogleScholarGoogle Scholar |

[5]  Chesson HW, Blandford JM, Gift TL, Tao GY, Irwin KL. The estimated direct medical cost of sexually transmitted diseases among American youth, 2000. Perspect Sex Reprod Health 2004; 36 11–9.
The estimated direct medical cost of sexually transmitted diseases among American youth, 2000.Crossref | GoogleScholarGoogle Scholar |

[6]  Owusu-Edusei K, Chesson HW, Gift TL. The economic burden of pediculosis pubis and scabies infections treated on an outpatient basis in the United States: evidence from private insurance claims data, 2001–2005. Sex Transm Dis 2009; 36 297–9.
The economic burden of pediculosis pubis and scabies infections treated on an outpatient basis in the United States: evidence from private insurance claims data, 2001–2005.Crossref | GoogleScholarGoogle Scholar |

[7]  Owusu-Edusei K, Gift TL, Chesson HW. Treatment cost of acute gonococcal infections: estimates from employer-sponsored private insurance claims data in the United States, 2003–2007. Sex Transm Dis 2010; 37 316–8.

[8]  Owusu-Edusei K, Hoover KW, Tao G. Estimating the direct outpatient medical cost per episode of primary and secondary syphilis in the United States: insured population perspective, 2003–2007. Sex Transm Dis 2011; 38 175–9.
Estimating the direct outpatient medical cost per episode of primary and secondary syphilis in the United States: insured population perspective, 2003–2007.Crossref | GoogleScholarGoogle Scholar |

[9]  Owusu-Edusei K, Tejani MN, Gift TL, Kent CK, Tao G. Estimates of the direct cost per case and overall burden of trichomoniasis for the employer-sponsored privately insured women population in the United States, 2001 to 2005. Sex Transm Dis 2009; 36 395–9.
Estimates of the direct cost per case and overall burden of trichomoniasis for the employer-sponsored privately insured women population in the United States, 2001 to 2005.Crossref | GoogleScholarGoogle Scholar |

[10]  Chesson HW, Gift TL, Owusu-Edusei K, Tao G, Johnson AP, Kent CK. A brief review of the estimated economic burden of sexually transmitted diseases in the United States: inflation-adjusted updates of previously published cost studies. Sex Transm Dis 2011; 38 889–91.

[11]  Owusu-Edusei K, Doshi SR, Apt BS, Gift TL. The direct cost of chlamydial infections: estimates for the employer-sponsored privately insured population in the United States, 2003–2007. Sex Transm Dis 2010; 37 519–21.

[12]  Bagalman E, Yu-Isenberg KS, Durden E, Crivera C, Dirani R, Bunn WB. Indirect costs associated with nonadherence to treatment for bipolar disorder. J Occup Environ Med 2010; 52 478–85.
Indirect costs associated with nonadherence to treatment for bipolar disorder.Crossref | GoogleScholarGoogle Scholar |

[13]  Curkendall S, Ruiz KM, Joish V, Mark TL. Productivity losses among treated depressed patients relative to healthy controls. J Occup Environ Med 2010; 52 125–30.
Productivity losses among treated depressed patients relative to healthy controls.Crossref | GoogleScholarGoogle Scholar |

[14]  Meadows ES, Johnston SS, Cao Z, Foley KA, Pohl GM, Johnston JA, et al Illness-associated productivity costs among women with employer-sponsored insurance and newly diagnosed breast cancer. J Occup Environ Med 2010; 52 415–20.
Illness-associated productivity costs among women with employer-sponsored insurance and newly diagnosed breast cancer.Crossref | GoogleScholarGoogle Scholar |

[15]  Truven Health Analytics (THA). Marketscan Research Database: User Guide and Database Dictionary. Ann Arbor: THA; 2011.

[16]  DeNavas-Walt C, Proctor DB, Smith JC, United States Census Bureau. Current population reports: income, poverty, and health insurance coverage in the United States, 2011. Washington DC: U.S. Government Printing Office2012. Available from: http://www.census.gov/prod/2012pubs/p60-243.pdf.

[17]  Bureau of Labor Statistics (BLS). Occupational employment statistics: May 2011 National occupational employment and wage estimates, United States. Washington DC: Division of Occupational Employment Statistics, BLS; 2012. Available online at: http://www.bls.gov/oes/current/oes_nat.htm [verified April 2012].

[18]  Bureau of Labor Statistics (BLS). Economic news release: employer costs for employee compensation news release text. Office of Compensation and Working Conditions, BLS; 2012. Available online at: http://www.bls.gov/news.release/ecec.nr0.htm [verified April 2012].

[19]  Blandford JM, Gift TL. Productivity losses attributable to untreated chlamydial infection and associated pelvic inflammatory disease in reproductive-aged women. Sex Transm Dis 2006; 33 S117–21.
Productivity losses attributable to untreated chlamydial infection and associated pelvic inflammatory disease in reproductive-aged women.Crossref | GoogleScholarGoogle Scholar |

[20]  Washington AE, Johnson RE, Sanders LL. Chlamydia trachomatis infections in the United States – what are they costing us? JAMA 1987; 257 2070–2.
Chlamydia trachomatis infections in the United States – what are they costing us?Crossref | GoogleScholarGoogle Scholar |

[21]  Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59 1–110.

[22]  Henderson T, Shepheard J, Sundararajan V. Quality of diagnosis and procedure coding in ICD-10 administrative data. Med Care 2006; 44 1011–9.
Quality of diagnosis and procedure coding in ICD-10 administrative data.Crossref | GoogleScholarGoogle Scholar |

[23]  Eng T, Butler W, eds. The hidden epidemic: confronting sexually transmitted diseases. Washington DC: Institute of Medicine, National Academy Press; 1997.

[24]  Cunningham SD, Kerrigan DL, Jennings JM, Ellen JM. Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents. Perspect Sex Reprod Health 2009; 41 225–30.
Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents.Crossref | GoogleScholarGoogle Scholar |

[25]  Cunningham SD, Tschann J, Gurvey JE, Fortenberry JD, Ellen JM. Attitudes about sexual disclosure and perceptions of stigma and shame. Sex Transm Infect 2002; 78 334–8.
Attitudes about sexual disclosure and perceptions of stigma and shame.Crossref | GoogleScholarGoogle Scholar |

[26]  Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimley DM, et al Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 2002; 92 378–81.
Relationships of stigma and shame to gonorrhea and HIV screening.Crossref | GoogleScholarGoogle Scholar |

[27]  Lichtenstein B, Hook EW, Sharma AK. Public tolerance, private pain: stigma and sexually transmitted infections in the American Deep South. Cult Health Sex 2005; 7 43–57.
Public tolerance, private pain: stigma and sexually transmitted infections in the American Deep South.Crossref | GoogleScholarGoogle Scholar |

[28]  Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis 2005; 191 S115–22.
Social context, sexual networks, and racial disparities in rates of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar |

[29]  Aral SO, Holmes KK. The epidemiology of STIs and their social and behavioral determinants: industrialized and developing countries. In Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al., editors. Sexually Transmitted Diseases. New York: McGraw Hill; 2008. pp. 53–92.

[30]  Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2011. Atlanta: U.S. Department of Health and Human Services; 2012.

[31]  Gold MR, Siegel JE, Russell LB, Weinstein MC, eds. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.

[32]  Sheeder J, Stevens-Simon C, Lezotte D, Glazner J, Scott S. Cervicitis: to treat or not to treat? The role of patient preferences and decision analysis. J Adolesc Health 2006; 39 887–92.
Cervicitis: to treat or not to treat? The role of patient preferences and decision analysis.Crossref | GoogleScholarGoogle Scholar |