Lost Workdays from Treating Type 2 Diabetes–Related Complications in Hong Kong: A Population-Based Cohort Study

Abstract

To estimate the lost workdays associated with type 2 diabetes and related complications in Hong Kong in 2017 and inform productivity loss and indirect costs. Using population-representative data of 540,370 people with type 2 diabetes managed in the public sector, we fitted a negative binomial regression model to investigate the association of diabetes complications on length of stay. Model fit was assessed by Akaike information criterion. A total of 4.28 million workdays (mean 7.93, 95% CI 7.88-7.97) was lost in 2017. Table 1 shows the regression coefficients: interpreted as the expected log (length of stay) increase for each one-unit increase in the corresponding variable. For example, the adjusted length of stay for 60-year male without any complication is 6.82 days (95% CI 5.52-8.43) . Hemodialysis contributed to the longest length of stay, followed by renal failure, skin ulcer, amputation, heart failure, cerebrovascular disease, atrial fibrillation, neuropathy, peripheral vascular disease, cataract, myocardial infarction, retinopathy, and ischemic heart disease. Enrolment in the multidisciplinary Risk Assessment and Management Programme was associated with reduced length of stay. This lost workday analysis helps to inform the indirect costs of diabetes in terms of lost productivity, and is essential for estimating the total economic loss from diabetes.