Parents of a child with juvenile rheumatoid arthritis (JIA) missed nearly triple the work hours as parents whose child did not have the disease, researchers reported.
Over the course of a 9-year observation period, parents of JIA children missed a mean of 281.8 hours from work versus parents in a control cohort, who missed a mean of 183.4 work hours (P=0.003), reported of the University of Kansas in Lawrence, and colleagues.
The number of missed work hours among parents with a JIA child was nearly 2.78 times greater, and work-time loss occurred most often during the first year after the child's diagnosis, they wrote in Rheumatology.
They also noted that male parents were also almost three times as likely to report losing time from work as female parents (odds ratio 2.81, P=0.008).
But the authors cautioned that "this difference is difficult to explain in light of the fact that all parents were employed over the 2 years of observation. However, it could be attributed to residual confounding;" specifically, the authors did not control for changes in "parental health status, education level, health insurance coverage, employment status, income level, or ethnicity."
"Children with JIA experience significant long-term health effects, including pain, disability and psychological distress," Rasu's group explained. "And parents of a child with JIA are likely to incur high medical costs due to their offspring's frequent visits to physicians and therapists to manage the disease. This study provides evidence that the burden of caring for a child with JIA impacts a parent's ability to work, leading to a decrease in work productivity, specifically during the year following the child's initial diagnosis."
For this research, data were taken from the . The U.S. database includes claims for approximately 100 employers and covers over 60 million lives. MarketScan claims data from the year 2000 through 2009 were used to identify incident JIA cases.
The mean age of the parents included in the study was 42.6 years. Some 47% were from the southern U.S. and 71% were male.
The majority of parents (89%0 worked full time and almost two-thirds of parents in both groups worked in the transportation and utilities industry.
The mean age of children with JIA was 10.6 years.
Among parents with a child diagnosed with JIA, the mean annual average number of work hours missed was 51.7 versus a mean annual average of 34.01 hours for control parents.
Slightly over half of parents with a child diagnosed with JIA also reported an increase in the number of missed hours worked a year before the child's diagnosis as well as the year after, whereas only about one-third of control patients reported missing work during the same 2-year interval.
"Parents of JIA cases missed 32.3 more work hours during the year after their child's JIA diagnosis than before the diagnosis was made (P=0.027)," the investigators stated.
In fact, parents of children without JIA were 64% less likely to experience work-time loss than parents with a child with JIA, they added.
Analyses also showed that parents residing in the Northeast were more likely to report work-time loss than those residing in the Midwest (OR 0.20, 95% CI 0.07-0.57) or the South (OR 0.37 95% CI 0.15, 0.93).
Having a child diagnosed with JIA was determined to be an independent predictor of work-time loss over a 2-year period.
"Work-time loss or work absenteeism has been determined to affect work productivity, and our findings indicate that more than half of all parents who have a child with JIA experienced work-time loss during the year following their child's diagnosis," the authors observed. "And our study indicates that JIA results in substantial productivity losses for the parents of affected children."
The authors also calculated that based on seasonally adjusted monthly estimates in 2005 dollars, parents who had a child with JIA lost an average of $4,589.37 due to missed work hours over the course of the 9-year analysis compared with $2,986.08 for control parents.
The study had some limitations. First, the results can only be generalized to people with employee-sponsored insurance. Also, the estimates may be biased because of the inherent limitations of the data analyzed. Finally, "the majority of the study parents worked in the transportation and utilities industry so caution should be exercised when generalizing the results to other industries," the authors wrote.
Disclosures
The study was funded by AbbVie. Some co-authors are current or former employees of AbbVie.
Rasu and co-authors disclosed relevant relationships with AbbVie.
Primary Source
Rheumatology
Rafia R, et al "Impact of JIA on parents' work absences" Rheumatology 2014; DOI: 10.1093/rheumatology/keu414.