• J Formos Med Assoc · Nov 2024

    Review

    Effective prevention in clinical practice may save human capital loss: Real-world evidence from Taiwan's National Health Insurance.

    • Fuhmei Wang, Wen-Yen Huang, Yu-Tzu Chang, Szu-Chun Yang, and Jung-Der Wang.
    • Department of Economics, College of Social Science, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    • J Formos Med Assoc. 2024 Nov 1; 123 Suppl 3: S251S258S251-S258.

    Background/PurposeEffective prevention could protect the health of the workforce, save human capital loss, and maintain employee productivity as well as economic growth.MethodsUsing real-world data of patients with end-stage kidney disease (ESKD) and lung cancer, we multiplied their lifetime survival functions with employment ratios and working salaries to estimate the lifetime employment durations and earnings. They were compared with corresponding age-, sex-, and calendar year-matched referents to assess the differences in loss of lifetime employment duration and earnings. From 2000 to 2017, 83,358 patients with end-stage kidney disease (ESKD) were associated with 32-66% lifetime productivity losses. Similarly, we collected 24,904 incident cases of lung adenocarcinoma during 2011-2018 and estimated the potential savings in human capital due to early detection. Based on the evolving trends of ESKD incidence rates in Taiwan, we calculated the lifetime human capital losses of ESKD patients in GDP (gross domestic product) percentages during 2000-2020.ResultsThe aggregate lifetime productivity losses of ESKD in terms of GDP% varied between 0.000398% and 0.01% for male patients and between 0.0001% and 0.009% for female patients. The younger the patients, the bigger the losses in GDP%. Similarly, early detection of lung adenocarcinoma saved lives and productivity to some extent.ConclusionsSuccessful prevention of catastrophic illnesses at early stages would save the lifetime employment duration and productivity of the workforce. Future reform on the NHI could consider closer coordination between public health and healthcare organizations, focusing on effective prevention of diseases and complications to save productivity loss.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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