학술논문
Joblessness and Lost Earnings after Acute Respiratory Distress Syndrome in a 1-Year National Multicenter Study
Document Type
article
Author
Kamdar, Biren B; Huang, Minxuan; Dinglas, Victor D; Colantuoni, Elizabeth; von Wachter, Till M; Hopkins, Ramona O; Needham, Dale M; Hudson, L; Gundel, S; Hough, C; Neff, M; Sims, K; Ungar, A; Watkins, T; Steingrub, J; Tidswell, M; Braden, E; DeSouza, L; Kardos, C; Kozikowski, L; Ouellette, S; Guntupalli, K; Bandi, V; Pope, C; Ross, C; Brower, R; Fessler, H; Hager, D; Mendez-Tellez, P; Needham, D; Oakjones, K; Sevransky, J; Workneh, A; Shanholtz, C; Herr, D; Howes, H; Netzer, G; Rock, P; Sampaio, A; Titus, J; Sloane, P; Beck, T; Highfield, D; King, S; Lee, B; Bolouri, N; Wiedemann, HP; Ashton, RW; Culver, DA; Frederick, T; Guzman, JA; Komara, JJ; Reddy, AJ; Hejal, R; Andrews, M; Haney, D; Connors, AF; Lasalvia, S; Thornton, JD; Warren, EL; Moss, M; Burnham, EL; Gray, L; Maloney, J; Mealer, M; Douglas, I; Overdier, K; Thompson, K; Wolken, R; Frankel, S; McKeehan, J; Warner, ML; Bost, T; Higgins, C; Hodgin, K; MacIntyre, N; Brown, L; Cox, C; Gentile, M; Govert, J; Knudsen, N; Carson, S; Chang, L; Choudhury, S; Hall, W; Lanier, J; Wheeler, AP; Bernard, GR; Hays, M; Mogan, S; Rice, TW; Hite, RD; Harvey, A; Morris, PE; Ragusky, M; Wright, P; Groce, S; McLean, J; Overton, A; Truwit, J
Source
American Journal of Respiratory and Critical Care Medicine. 196(8)
Subject
Language
Abstract
RationaleFollowing acute respiratory distress syndrome (ARDS), joblessness is common but poorly understood.ObjectivesTo evaluate the timing of return to work after ARDS, and associated risk factors, lost earnings, and changes in healthcare coverage Methods: Over 12-month longitudinal follow-up, ARDS survivors from 43 U.S. ARDSNet hospitals provided employment and healthcare coverage data via structured telephone interviews. Factors associated with the timing of return to work were assessed using Fine and Gray regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data.Measurements and main resultsOf 922 consenting survivors, 386 (42%) were employed before ARDS (56% male; mean ± SD age, 45 ± 13 yr), with seven dying by 12-month follow-up. Of 379 previously employed 12-month survivors, 166 (44%) were jobless at 12-month follow-up. Accounting for competing risks of death and retirement, half of enrolled and previously employed survivors returned to work by 13 weeks after hospital discharge, with 68% ever returning by 12 months. Delays in return to work were associated with longer hospitalization and older age among nonwhite survivors. Over 12-month follow-up, 274 (71%) survivors accrued lost earnings, averaging $26,949 ± $22,447 (60% of pre-ARDS annual earnings). Jobless survivors experienced a 14% (95% confidence interval, 5-22%; P = 0.002) absolute decrease in private health insurance (from 44% pre-ARDS) and a 16% (95% confidence interval, 7-24%; P