The Risk of Withdrawal from Labor Force in Patients with Schizophrenia

• Main Authors: Kuan-Chih Huang, 黃冠誌
• Other Authors: Chao-Hsiun Tang
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/57788288303500223744

碩士 === 臺北醫學大學 === 醫務管理學研究所 === 98 === OBJECTIVES: This study aimed to estimate the withdrawal rate from the labor market among patients with schizophrenia in Taiwan. METHODS: The data source was the Psychiatric Inpatients Medical Claims Data (PIMC) from the National Health Research Institute (NHRI), Taiwan. The PIMC compiled all the health records during 1996-2002 for patients who had at least one psychiatric hospitalization during 1996-2001. The inclusion criteria were patients who: 1) had their initial psychiatric health record within 1998 to 2001; 2) had primary or secondary ICD-9-CM diagnosis of schizophrenia; 3) were under employment; and 4) were aged between 18 and 65. The final sample available for the analyses was 7,980 (1,596 for schizophrenia; 6,384 for control group). An index date was created by subtracting 365 days from the date of initial health record for examining the impact of the disease on withdrawal pre and post of disease onset. To identify all withdrawal events, each case was tracked from the index date until December 31, 2002 or death, whichever came first. All cases without events were censored on December 31, 2002. Kaplan-Meier method and Cox Proportional Hazard Model were used to estimate cumulated employment rates and the risk of withdrawal from the labor force. RESULTS: For patients with schizophrenia, withdrawal rate of 25% was found during one year before the disease onset. During one year before and one after the disease onset, the withdrawal rate increased to 56%. During one year before and four year after the disease onset, the rate raised to 78%. Similar patterns were observed for patients with bipolar/depression, with the corresponding rate equaling 25%, 56%, and 75%. Median employment time (95% CI) was 423.0 days (397.0, 460.0) for patients with schizophrenia. Moreover, patients with schizophrenia have higher risks of withdrawal from labor force than those without mental illness (HR: 2.515, 95% CI：2.334 - 2.710, p<0.0001). CONCLUSIONS: Schizophrenia was showed to have adverse impacts on labor participation.