Joblessness and Lost Earnings after Acute Respiratory Distress Syndrome in a 1-Year National Multicenter Study.

Autor:	Kamdar BB; 1 Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California., Huang M; 2 Outcomes after Critical Illness and Surgery Group.; 3 Division of Pulmonary and Critical Care Medicine, and., Dinglas VD; 2 Outcomes after Critical Illness and Surgery Group.; 3 Division of Pulmonary and Critical Care Medicine, and., Colantuoni E; 2 Outcomes after Critical Illness and Surgery Group.; 4 Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., von Wachter TM; 5 Department of Economics, University of California, Los Angeles, Los Angeles, California., Hopkins RO; 6 Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah.; 7 Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah; and.; 8 Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah., Needham DM; 2 Outcomes after Critical Illness and Surgery Group.; 3 Division of Pulmonary and Critical Care Medicine, and.; 9 Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland.
Jazyk:	angličtina
Zdroj:	American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2017 Oct 15; Vol. 196 (8), pp. 1012-1020.
DOI:	10.1164/rccm.201611-2327OC
Abstrakt:	Rationale: Following acute respiratory distress syndrome (ARDS), joblessness is common but poorly understood. Objectives: To evaluate the timing of return to work after ARDS, and associated risk factors, lost earnings, and changes in healthcare coverage Methods: Over 12-month longitudinal follow-up, ARDS survivors from 43 U.S. ARDSNet hospitals provided employment and healthcare coverage data via structured telephone interviews. Factors associated with the timing of return to work were assessed using Fine and Gray regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data. Measurements and Main Results: Of 922 consenting survivors, 386 (42%) were employed before ARDS (56% male; mean ± SD age, 45 ± 13 yr), with seven dying by 12-month follow-up. Of 379 previously employed 12-month survivors, 166 (44%) were jobless at 12-month follow-up. Accounting for competing risks of death and retirement, half of enrolled and previously employed survivors returned to work by 13 weeks after hospital discharge, with 68% ever returning by 12 months. Delays in return to work were associated with longer hospitalization and older age among nonwhite survivors. Over 12-month follow-up, 274 (71%) survivors accrued lost earnings, averaging $26,949 ± $22,447 (60% of pre-ARDS annual earnings). Jobless survivors experienced a 14% (95% confidence interval, 5-22%; P = 0.002) absolute decrease in private health insurance (from 44% pre-ARDS) and a 16% (95% confidence interval, 7-24%; P < 0.001) absolute increase in Medicare and Medicaid (from 33%). Conclusions: At 12 months after ARDS, nearly one-half of previously employed survivors were jobless. Post-ARDS joblessness is associated with readily identifiable patient and hospital variables and accompanied by substantial lost earnings and a shift toward government-funded healthcare coverage.
Databáze:	MEDLINE
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