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Wednesday, 20 October 2004 - 11:15 AM

This presentation is part of: Oral Concurrent Session B - Health Economics

COMBINING REGISTRY, PRIMARY, AND SECONDARY DATA SOURCES TO IDENTIFY THE IMPACT OF CANCER ON LABOR MARKET OUTCOMES

CATHY J. BRADLEY, PhD, MPA, Michigan State University, Medicine, East Lansing, MI, David Neumark, PhD, Public Policy Institute of California, Public Policy Institute of California, San Francisco, CA, Kathleen Oberst, MA, Michigan State University, Institute for Health Care Studies, East Lansing, MI, Simone Brennan, MA, Wayne State University, Karmanos Cancer Institute, Detroit, MI, and Maryjean Schenk, MD, Wayne State University, Family Medicine, Detroit, MI.

Purpose. We developed a research agenda to study the labor market outcomes attributable to detection and treatment for cancer, and developed a research design and data collection strategy that improves upon other research addressing these questions. Methods. We identified an inception cohort of women with breast cancer (n=496), men with prostate cancer (n=294), and corresponding control groups, and followed their labor market outcomes for a period of 18 months. The main outcomes were changes in employment, hours worked and wages, which prior research have shown to be correlated with health, and reductions in which are a major contributor to the productivity losses. We also critically assessed how well our study design and data collection strategy accomplished its objectives. Results. The study performed well in recruiting subjects from a population-based data source, constructing a control group from the Current Population Survey (CPS), and implementing a longitudinal design, with a 90% subject retention rate, that reflects the natural course of cancer’s ill effects within the first years following diagnosis. Using the CPS, we demonstrated that simply reporting employment transitions from a cohort of cancer survivors without a control group overstates the non-employment effect of cancer. Nevertheless, the CPS control sample was not a perfect match to the cancer sample in terms of income and socioeconomic status. Overall, the negative effect of cancer was greatest 6 months following diagnosis relative to the control sample. At 12 and 18 months following diagnosis, many subjects return to work. Breast cancer’s non-employment effect appears to be twice as large for African-American women. Conclusions. Although our research is specific to cancer, the issues raised and addressed are relevant to the study of a number of chronic diseases. If the economic consequences of disease are to be seriously examined so that their results are meaningful for policy makers and treatment providers, researchers investigating labor market outcomes must take considerable care in their study design, instrument validity, sample selection, and data collection, as well as in the execution of the study. The methods used to estimate productivity loss and other economic outcomes attributable to these conditions require careful scrutiny so that reliable findings can be used to shape health care decisions and policy.


See more of Oral Concurrent Session B - Health Economics
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)