University of Oulu

Rissanen, I., Ala-Mursula, L., Nerg, I. et al. Adjusted productivity costs of stroke by human capital and friction cost methods: a Northern Finland Birth Cohort 1966 study. Eur J Health Econ 22, 531–545 (2021).

Adjusted productivity costs of stroke by human capital and friction cost methods : a Northern Finland Birth Cohort 1966 study

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Author: Rissanen, Ina1,2,3; Ala-Mursula, Leena1; Nerg, Iiro4;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Huispost nr. STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
4Oulu Business School, Department of Economics, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Springer Nature, 2021
Publish Date: 2021-07-08


Background: Productivity costs result from loss of paid and unpaid work and replacements due to morbidity and mortality. They are usually assessed in health economic evaluations with human capital method (HCM) or friction cost method (FCM). The methodology for estimating lost productivity is an area of considerable debate.

Objective: To compare traditional and adjusted HCM and FCM productivity cost estimates among young stroke patients.

Methods: The Northern Finland Birth Cohort 1966 was followed until the age of 50 to identify all 339 stroke patients whose productivity costs were estimated with traditional, occupation-specific and adjusted HCM and FCM models by using detailed, national register-based data on care, disability, mortality, education, taxation and labour market.

Results: Compared to traditional HCM, taking into account occupational class, national unemployment rate, disability-free life expectancy and decline in work ability, the productivity cost estimate decreased by a third, from €255,960 to €166,050. When traditional FCM was adjusted for occupational class and national unemployment rate, the estimate more than doubled from €3,040 to €7,020. HCM was more sensitive to adjustments for discount rate and wage growth rate than FCM.

Conclusions: This study highlights the importance of adjustments of HCM and FCM. Routine register-based data can be used for accurate productivity cost estimates of health shocks.

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Series: European journal of health economics
ISSN: 1618-7598
ISSN-E: 1618-7601
ISSN-L: 1618-7598
Volume: 22
Issue: 4
Pages: 531 - 545
DOI: 10.1007/s10198-021-01271-7
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
316 Nursing
511 Economics
Funding: NFBC1966 received financial support from University of Oulu [Grant no. 65354, 24000692]; Oulu University Hospital [Grant no. 2/97, 8/97, 24301140]; Ministry of Health and Social Affairs [Grant no. 23/251/97, 160/97, 190/97]; National Institute for Health and Welfare, Helsinki [Grant no. 54121]; Regional Institute of Occupational Health, Oulu, Finland [Grant no. 50621, 54231]; and ERDF European Regional Development Fund [Grant no. 539/2010 A31592]. This work was supported by Orion Research Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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