title: Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.
abstract: Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system.
authors.affiliation: Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark. NMN@ssi.dk.
authors.forename: Nete Munk
authors.initials: NM
authors.lastname: Nielsen
authors.affiliation: The PTU Rehabilitation Centre, Fjeldhammervej 8, 2610, Rødovre, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Kay
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Center for Healthy Ageing, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Benedikte
authors.initials: B
authors.lastname: Wanscher
authors.affiliation: Danish Institute for Local and Regional Government Research, Copenhagen, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Ibsen
authors.affiliation: Danish Institute for Local and Regional Government Research, Copenhagen, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Kjellberg
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Center for Healthy Ageing, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017281:Cost of Illness; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011051:Poliomyelitis / Q000191:economics* / Q000453:epidemiology; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Health care cost; Long-term consequences; Poliomyelitis; Socio-economic