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Sugisawa H, Shimizu Y, Kumagai T, Shishido K, Koda Y, Shinoda T. Employment rates for working-age patients receiving hemodialysis increasing: Changing economic environment. Ther Apher Dial 2024. [PMID: 38647125 DOI: 10.1111/1744-9987.14127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/21/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION This study explored employment trends among working-age patients undergoing hemodialysis using 5-year surveys from 1996 to 2021. Policy changes affecting individuals with disabilities, the economic environment, and employment status among the general population in Japan were considered. Differences in trends by gender and health status were examined. METHODS Employment status was categorized into employment and nonemployment; and regular, nonregular, and self. Analytical data with similar characteristics were generated over the six surveys using the propensity score method. RESULTS The employment rate, especially among women, increased from 1996 to 2021. However, the employment rate ratio to the general population was approximately 80% for men and 50% for women, even in 2021. The employment rate increased with an expansion in nonregular employment. Women's employment trends could be explained by changes in real gross domestic product and employment quotas for individuals with disabilities. CONCLUSION Employment trends differ by gender and by regular versus nonregular employment.
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Affiliation(s)
- Hidehiro Sugisawa
- J. F. Oberlin University Graduate School of International Studies, Shibuya-ku, Tokyo, Japan
| | - Yumiko Shimizu
- The Jikei University School of Nursing, Chofu, Tokyo, Japan
| | - Tamaki Kumagai
- School of Health Sciences, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | | | - Yutaka Koda
- Koda Medical and Dialysis Clinic, Tsubame, Niigata, Japan
| | - Toshio Shinoda
- Department of Clinical Engineering Advanced Course, Teikyo University Junior College, Shibuya, Tokyo, Japan
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Choi S, Jang SY, Choi E, Park YS. Association between prevalence and severity of chronic kidney disease and employment status: a nationwide study in Korea. BMC Public Health 2024; 24:216. [PMID: 38238668 PMCID: PMC10797861 DOI: 10.1186/s12889-023-17338-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/25/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) is increasing globally, and understanding the association between CKD and employment status is crucial. This cross-sectional study aimed to investigate the association of CKD with employment and occupation type among patients with CKD. METHODS We analyzed data from 36,732 Korean adults aged ≥ 30 years, who participated in the Korean National Health and Nutrition Examination Survey between 2014 and 2021. CKD was detected based on the estimated glomerular filtration rate, and the employment status of the participants was classified into distinct categories: full-time permanent employment, unemployment, self-employment, and precarious employment. We analyzed the data using multiple logistic regression. RESULTS We observed a significant association between CKD and a higher likelihood of unemployment compared to that in individuals without CKD (odds ratio, 1.70; 95% confidence interval, 1.47-1.96). This association was more prominent in patients with severe CKD. In the multivariable logistic analysis, patients with CKD had a higher likelihood for precarious employment (odds ratio, 1.29; 95% confidence interval, 0.92-1.88), self-employment (odds ratio, 1.3; 95% confidence interval, 0.90-1.88), and unemployment (odds ratio, 2.10; 95% confidence interval, 1.51-2.92) compared to individuals without CKD. CONCLUSIONS Our study demonstrated that CKD is associated with a higher likelihood of unemployment and engagement in precarious employment. These findings highlight the challenges faced by patients with CKD in obtaining stable employment and emphasize the need for interventions to improve the employment outcomes of individuals with CKD.
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Affiliation(s)
- Seoyeong Choi
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eunjeong Choi
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
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Purtell L, Bennett P, Bonner A. Multimodal approaches for inequality in kidney care: turning social determinants of health into opportunities. Curr Opin Nephrol Hypertens 2024; 33:34-42. [PMID: 37847046 DOI: 10.1097/mnh.0000000000000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE OF REVIEW Kidney disease is associated with major health and economic burdens worldwide, disproportionately carried by people in low and middle socio-demographic index quintile countries and in underprivileged communities. Social determinants such as education, income and living and working conditions strongly influence kidney health outcomes. This review synthesised recent research into multimodal interventions to promote kidney health equity that focus on the social determinants of health. RECENT FINDINGS Inequity in kidney healthcare commonly arises from nationality, race, sex, food insecurity, healthcare access and environmental conditions, and affects kidney health outcomes such as chronic kidney disease progression, dialysis and transplant access, morbidity and mortality. Multimodal approaches to addressing this inequity were identified, targeted to: patients, families and caregivers (nutrition, peer support, financial status, patient education and employment); healthcare teams (workforce, healthcare clinician education); health systems (data coding, technology); communities (community engagement); and health policy (clinical guidelines, policy, environment and research). SUMMARY The engagement of diverse patients, families, caregivers and communities in healthcare research and implementation, as well as clinical care delivery, is vital to counteracting the deleterious effects of social determinants of kidney health.
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Affiliation(s)
- Louise Purtell
- School of Nursing and Midwifery
- Menzies Health Institute Queensland, Griffith University
- Research Development Unit, Caboolture Hospital, Metro North Health
- Kidney Health Service, Metro North Health, Queensland, Australia
| | - Paul Bennett
- School of Nursing and Midwifery
- Menzies Health Institute Queensland, Griffith University
| | - Ann Bonner
- School of Nursing and Midwifery
- Menzies Health Institute Queensland, Griffith University
- Kidney Health Service, Metro North Health, Queensland, Australia
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Quist SW, van Schoonhoven AV, Bakker SJL, Pochopień M, Postma MJ, van Loon JMT, Paulissen JHJ. Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands. Cardiovasc Diabetol 2023; 22:328. [PMID: 38017448 PMCID: PMC10685667 DOI: 10.1186/s12933-023-02053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/04/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND In the Netherlands, more than one million patients have type 2 diabetes (T2D), and approximately 36% of these patients have chronic kidney disease (CKD). Yearly medical costs related to T2D and CKD account for approximately €1.3 billion and €805 million, respectively. The FIDELIO-DKD trial showed that the addition of finerenone to the standard of care (SoC) lowers the risk of CKD progression and cardiovascular (CV) events in patients with CKD stages 2-4 associated with T2D. This study investigates the cost-effectiveness of adding finerenone to the SoC of patients with advanced CKD and T2D compared to SoC monotherapy. METHODS The validated FINE-CKD model is a Markov cohort model which simulates the disease pathway of patients over a lifetime time horizon. The model was adapted to reflect the Dutch societal perspective. The model estimated the incremental costs, utilities, and incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were performed to assess the effect of parameter uncertainty on model robustness. RESULTS When used in conjunction with SoC, finerenone extended time free of CV events and renal replacement therapy by respectively 0.30 and 0.31 life years compared to SoC alone, resulting in an extension of 0.20 quality-adjusted life years (QALYs). The reduction in renal and CV events led to a €6136 decrease in total lifetime costs per patient compared to SoC alone, establishing finerenone as a dominant treatment option. Finerenone in addition to SoC had a 83% probability of being dominant and a 93% probability of being cost-effective at a willingness-to-pay threshold of €20,000. CONCLUSION By reducing the risk of CKD progression and CV events, finerenone saves costs to society while gaining QALYs in patients with T2D and advanced CKD in the Netherlands.
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Affiliation(s)
- Sara W Quist
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands.
- Asc Academics, Groningen, The Netherlands.
| | - Alexander V van Schoonhoven
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
| | | | - Maarten J Postma
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | | | - Jeroen H J Paulissen
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
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Yabe H, Tabata A, Sugimoto N, Saeki T, Tsukada T, Mohara J. Factors affecting presenteeism in workers with nocturnal hemodialysis: A two-center cross-sectional study. Ther Apher Dial 2023; 27:866-874. [PMID: 37231563 DOI: 10.1111/1744-9987.14023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Presenteeism and work dysfunction in dialysis patients should be assessed to improve disease management and work productivity. Therefore, this study aimed to investigate the prevalence and factors surrounding presenteeism and work dysfunction in workers with nocturnal hemodialysis. METHODS This multicenter cross-sectional study included 42 workers with nocturnal hemodialysis. Presenteeism was measured in patients using the Work Functioning Impairment Scale (WFun), employment status, exercise habit, and exercise self-efficacy (SE). RESULTS The WFun score was 12.5 ± 6.3 points, and patients with mild presenteeism were 12 (28.6%), moderate was 2 (4.8%), and severe was 1 (2.4%). Multiple regression analysis, which was adjusted for few confounding factors, showed that WFun had a significant relationship with lower exercise SE (r = -0.32) and normalized protein catabolism rate (r = 0.31). CONCLUSIONS Working patients with nocturnal hemodialysis had presenteeism and a significant correlation with exercise SE and nPCR. This study provides a framework to prevent work dysfunction in nocturnal hemodialysis patients.
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Affiliation(s)
- Hiroki Yabe
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
| | - Aki Tabata
- Department of Rehabilitation, Seirei Sakura Citizen Hospital, Sakura, Japan
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