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Prevalence, Indirect Costs, and Risk Factors for Work Disability in Patients with Crohn’s Disease at a Tertiary Care Center in Rio de Janeiro

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Abstract

Background and Aims

Crohn’s disease (CD) can lead to work disability with social and economic impacts worldwide. In Brazil, where its prevalence is increasing, we assessed the indirect costs, prevalence, and risk factors for work disability in the state of Rio de Janeiro and in a tertiary care referral center of the state.

Methods

Data were retrieved from the database of the Single System of Social Security Benefits Information, with a cross-check for aid pension and disability retirement. A subanalysis was performed with CD patients followed up at the tertiary care referral center using a prospective CD database, including clinical variables assessed as possible risk factors for work disability.

Results

From 2010 to 2018, the estimated prevalence of CD was 26.05 per 100,000 inhabitants, while the associated work disability was 16.6%, with indirect costs of US$ 8,562,195.86. Permanent disability occurred more frequently in those aged 40 to 49 years. In the referral center, the prevalence of work disability was 16.7%, with a mean interval of 3 years between diagnosis and the first benefit. Risk factors for absence from work were predominantly abdominal surgery, anovaginal fistulas, disease duration, and the A2 profile of the Montreal classification.

Conclusions

In Rio de Janeiro, work disability affects one-sixth of CD patients, and risk factors are associated with disease duration and complications. In the context of increasing prevalence, as this disability compromises young patients after a relatively short period of disease, the socioeconomic burden of CD is expected to increase in the future.

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Abbreviations

IBD:

Inflammatory bowel disease

CD:

Crohn’s disease

INSS:

National Institute of Social Security

SUIBE:

Unified Benefits Information System

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Acknowledgments

This work was supported by grants from the Brazilian Research Council (CNPq) (302401/2016-4) and the FAPERJ (Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro) (E26/202.781/2017).

Funding

This research was supported by grants from Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro-FAPERJ and Conselho Nacional de Desenvolvimento Científico e Tecnológico–CNPq.

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Authors and Affiliations

  1. Disciplina de Gastroenterologia e Endoscopia Digestiva, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, 20551-900, Brazil

    Renata de Sá Brito Fróes & Ana Teresa Pugas Carvalho

  2. Perícia Médica Federal (PMF), Superintendência Regional 9 da Subsecretaria de PMF do Ministério da Economia, Rio de Janeiro, RJ, 20030-030, Brazil

    Renata de Sá Brito Fróes, Adriana Maria Hilu de Barros Moreira & Camila Cesar Monnerat

  3. Disciplina de Proctologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, 20551-900, Brazil

    André da Luz Moreira

  4. D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo, Rio de Janeiro, RJ, 22281-100, Brazil

    André da Luz Moreira & Heitor Siffert Pereira de Souza

  5. Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil

    Antonio José de V. Carneiro & Heitor Siffert Pereira de Souza

  6. Instituto de Estudos de Saúde Coletiva (IESC), Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21944-970, Brazil

    Jessica P. L. Moreira & Ronir R. Luiz

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  1. Renata de Sá Brito Fróes
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  8. Heitor Siffert Pereira de Souza
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  9. Ana Teresa Pugas Carvalho
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Contributions

RSBF and ADLM participated in the conception and design of the study; the acquisition, analysis and interpretation of the data; and the drafting the manuscript. AJC, RRL, JPLM, AMHBM, and CCM participated in the acquisition, analysis, and interpretation of the data and in drafting parts of the manuscript. ATC and HSPdS participated in the conception and design of the study, obtained funding, analyzed and interpreted the data, and critically revised the manuscript for important intellectual content. All authors gave final approval of the submitted version of the manuscript.

Corresponding author

Correspondence to Heitor Siffert Pereira de Souza.

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de Sá Brito Fróes, R., da Luz Moreira, A., Carneiro, A.J.d. et al. Prevalence, Indirect Costs, and Risk Factors for Work Disability in Patients with Crohn’s Disease at a Tertiary Care Center in Rio de Janeiro. Dig Dis Sci 66, 2925–2934 (2021). https://doi.org/10.1007/s10620-020-06646-z

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