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Namita Tundia, Martha Skup, Rachael Sorg, Dendy Macaulay, Jingdong Chao, Parvez Mulani, Jennifer E Thorne; Risk of Leaving the Workforce in Non-infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5309.
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Non-infectious uveitis (NIU) is a spectrum of diseases characterized by intraocular inflammation of uvea that may cause disabling visual impairment. We assessed risk of leaving the workforce among privately insured US employees with non-anterior NIU compared with matched controls.
Patients aged 18-64 with ≥2 occurrences of diagnoses of non-anterior NIU (ICD-9: 360.12, 362.12, 362.18, 363.0x, 363.10-363.13, 363.15, 363.2x, 364.24) from 1/1/1998 to 3/31/2012 were identified in the OptumHealth claims database. Patients had continuous eligibility for ≥6 months before their first non-anterior NIU diagnosis (index date). Patients with non-anterior NIU (cases) were matched 1:1 by age, sex, region, employment status, and company to controls without a diagnosis of uveitis (infectious or non-infectious). Patients were actively employed on the index date and were followed until loss of insurance eligibility or until age 65. Risks of leaving the workforce (leave of absence, early retirement, short-term disability, or long-term disability) were compared between cases and controls using time-to-event Kaplan-Meier analysis and Cox proportional hazard regressions adjusting for baseline characteristics.
Cases and controls (N=776 each) were 61.9% male; mean age was 44.7 years. In unadjusted Kaplan-Meier analyses, risk of leaving the workforce was significantly higher in cases vs. controls (P=.0069); risk among cases at 5- and 10-years was 31.3% and 43.9% while that among controls was 23.4% and 33.1%, respectively (figure). Risks of leave of absence at 5- and 10-years were 14.9% and 19.8% for cases vs. 10.5% and 12.9% for controls; risk of long-term disability at 5- and 10-year were 3.7% and 6.0% for cases vs. 1.2% and 2.8% for controls (all comparisons P<.05). Risk of early retirement and short-term disability were also greater for NIU vs. controls; however, differences in time to early retirement and time to short-term disability were not statistically significant. Results were supported by regression analysis; cases were significantly more likely to leave the workforce over the course of follow-up vs. controls (adjusted hazard ratio=1.27, 95% CI=1.01-1.59, P=.039).
Compared with matched controls, patients with NIU were more likely to leave the workforce. Substantial burden due to loss of workforce participation is associated with NIU.
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