title: Paid expenditures and productivity costs associated with permanent disability pensions in patients with spinal disorders: Nationwide Finnish Register-based Study, 1990-2010.
abstract: OBJECTIVE
  The objective of this study is to present the paid expenditures and productivity costs of disability pensions (DP) due to spinal disorders (SD) in Finland during 1990-2010.
  
  
  METHODS
  This study is a register-based national study. All new cases aged 20-64 that were granted a DP due to SD were identified from the nationwide register maintained by the Finnish Centre of Pensions. The data included sex, age group, year of the DP decision, main cause of incapacity (diagnosis) leading to permanent DP and yearly paid expenditures for DPs. Annual productivity costs were estimated based on labour force participation rate and the employment rate adjusted gross domestic product.
  
  
  RESULTS
  A total of 39,107 individuals (18,072 females, 21,035 males) received DPs during the study period. SDs generated 9,372 million euros extra cost during this period due to DP (females 3.5 billion, males 5.9 billion). The total DP expenditures paid increased during the first half of 1990s but decreased during the second half of 1990s (-44.8 %). For degenerative SD cases, the DP expenditure was 5.1 billion €, disc disease 3.5 billion € and for other SDs 0.7 billion €. Males, compared to females, were expected to have a rate 1.22 times greater costs due to DPs. The estimated total annual productivity costs due to SDs have been over six times higher than expenditures paid for DPs per year. The costs of DPs are different compared to occurrence rates due to salary and early retirement age differences between genders.
  
  
  CONCLUSIONS
  Despite a significant decrease in DP-associated expenditures due to SDs after 1993, the annual expenditures have stayed on a high level in Finland.
authors: Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki University Hospital, University of Helsinki, Topeliuksenkatu 5, P.O. Box 266, 00029, Helsinki, Finland. tom.asklof@hus.fi.
authors: Tom
authors: T
authors: Asklöf
authors: Pharmacoeconomics and Outcomes Research Unit (PHORU), University of Eastern Finland, Kuopio, Finland.
authors: Janne
authors: J
authors: Martikainen
authors: Unit of Primary Health Care, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.|Unit of Primary Health Care, Department of General Practice, Kuopio University Hospital, Kuopio, Finland.
authors: Hannu
authors: H
authors: Kautiainen
authors: Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors: Maija
authors: M
authors: Haanpää
authors: Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki University Hospital, University of Helsinki, Topeliuksenkatu 5, P.O. Box 266, 00029, Helsinki, Finland.
authors: Ilkka
authors: I
authors: Kiviranta
authors: ORTON, Helsinki, Finland.
authors: Timo
authors: T
authors: Pohjolainen
mesh_terms: D000328:Adult; D017281:Cost of Illness; D017598:Efficiency, Organizational / Q000191:economics* / Q000706:statistics & numerical data; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data*; D012042:Registries; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data*; D013122:Spinal Diseases / Q000191:economics* / Q000628:therapy; D055815:Young Adult
keywords: Disability pension; Health care expenditures; Productivity costs; Register-based study; Spinal disorders
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