Lower respiratory tract infections: impact on the workplace.

BACKGROUND: While there is some literature on the cost of specific respiratory infections, much of the existing research focuses only on direct medical treatment costs and does not take into consideration workplace burden due to disability and absenteeism.

OBJECTIVE: To evaluate the impact of lower respiratory tract infections (LRTIs) on the workplace, specifically regarding the economic burden from an employer's perspective.

DESIGN: Specific LRTI considered here were acute bronchitis, acute exacerbations of chronic bronchitis and pneumonia. Data from medical, prescription drug and disability claims of a large, national company in the US were used. These data provide information on both the healthcare and work loss impacts of LRTI on this major self-insured employer. The annual per capita expenditures for persons with LRTI were determined for beneficiaries (including employees and dependants) of this employer by analysing all claims in 1997. Results were compared with those of a 10% random sample of beneficiaries in the employer's overall beneficiary population.

RESULTS: In 1997, total per person expenditures and total medical service utilisation were higher among beneficiaries with LRTI than among beneficiaries in the overall beneficiary population sample. Annual per capita employer expenditures for beneficiaries with LRTI totalled 6,116 US dollars, compared with 2,368 US dollars (1997 values) for the average beneficiary in the overall beneficiary population sample. Employer payments for lost work time through disability and absenteeism accounted for 17% of these expenditures amongst beneficiaries with LRTI and for 35% amongst employees with LRTI.

CONCLUSIONS: Annual per capita expenditures for beneficiaries with LRTI were almost three times that of the average beneficiary. We conclude that it is important to consider work loss in analyses of the cost of LRTI.