title: Labour productivity losses caused by premature death associated with hepatitis C in Spain.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) infection places a huge burden on healthcare systems. There is no study assessing the impact of HCV infection on premature deaths in Spain. The aim of this study was to estimate productivity losses because of premature deaths attributable to hepatitis C occurring in Spain during 2007-2011.
  
  
  METHODS
  We use data from several sources (Registry of Deaths, Labour Force Survey and Wage Structure Survey) to develop a simulation model based on the human capital approach and to estimate the flows in labour productivity losses in the period considered. The attributable fraction method was used to estimate the numbers of deaths associated with HCV infection. Two sensitivity analyses were developed to test the robustness of the results.
  
  
  RESULTS
  Our model shows total productivity losses attributable to HCV infection of 1054.7 million euros over the period analysed. The trend in productivity losses is decreasing over the period. This result is because of improvements in health outcomes, reflected in the reduction of the number of years of potential productive life lost. Of the total estimated losses, 18.6% were because of hepatitis C, 24.6% because of hepatocellular carcinoma, 30.1% because of cirrhosis, 15.9% because of other liver diseases and 10.7% because of HIV-HCV coinfection.
  
  
  CONCLUSIONS
  The results show that premature mortality attributable to hepatitis C involves significant productivity losses. This highlights the need to extend the analysis to consider other social costs and obtain a more complete picture of the actual economic impact of hepatitis C infection.
authors: aUniversity of Castille-La Mancha, Seminar of Research on Economy and Health bService of Gastroenterology, Fundacion Alcorcon University Hospital, University Rey Juan Carlos, Madrid, Spain.
authors: Juan
authors: J
authors: Oliva-Moreno
authors: Luz M
authors: LM
authors: Peña-Longobardo
authors: Sonia
authors: S
authors: Alonso
authors: Antonio
authors: A
authors: Fernández-Bolaños
authors: María Luisa
authors: ML
authors: Gutiérrez
authors: Álvaro
authors: Á
authors: Hidalgo-Vega
authors: Elsa
authors: E
authors: de la Fuente
authors: Conrado M
authors: CM
authors: Fernández-Rodríguez
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000191:economics* / Q000401:mortality / Q000821:virology; D060085:Coinfection / Q000191:economics / Q000401:mortality; D003198:Computer Simulation; D017281:Cost of Illness; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data; D015658:HIV Infections / Q000191:economics / Q000401:mortality; D019698:Hepatitis C, Chronic / Q000150:complications / Q000191:economics* / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000191:economics / Q000401:mortality / Q000821:virology; D008113:Liver Neoplasms / Q000191:economics* / Q000401:mortality / Q000821:virology; D008962:Models, Theoretical; D061213:Mortality, Premature; D013030:Spain / Q000453:epidemiology