title: Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes.
abstract: Permanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000-2013 at the Mexican Institute of Social Security.
  
  
  
  A cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan-Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 % CI) in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013).
  
  
  
  There were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29-1.50), agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15-1.73) and renal complications (HR, 3.49; 95 % CI, 3.18-3.83) had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013), and showed a sustained increment: from $58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5 %).
  
  
  
  Mexican workers with permanent occupational disability caused by diabetes had a median survival of 7.26 years, and those with renal complications showed the lowest survival in the cohort. Expenses derived from pension payments amounted to $ 777 million USD and showed an important increase from 2000 to 2013.
authors: Epidemiological Surveillance Coordination, Mexican Institute of Social Security, Mier y Pesado 120, Col. del Valle, Benito Juárez, 03100, Mexico City, Mexico.
authors: Iván de Jesús
authors: Ide J
authors: Ascencio-Montiel
authors: Fundación IMSS, A.C., Av. Paseo de la Reforma 476, Col. Juárez, Cuauhtémoc, 06600, Mexico City, Mexico.
authors: Jesús
authors: J
authors: Kumate-Rodríguez
authors: Primary Health Care Unit, Mexican Institute of Social Security, Hamburgo 18, Col. Juárez, Cuauhtémoc, 06600, Mexico City, Mexico.
authors: Víctor Hugo
authors: VH
authors: Borja-Aburto
authors: Epidemiological Surveillance Coordination, Mexican Institute of Social Security, Mier y Pesado 120, Col. del Valle, Benito Juárez, 03100, Mexico City, Mexico.
authors: José Esteban
authors: JE
authors: Fernández-Garate
authors: Division of Technical Studies, Coordination of Economic Benefits, Mexican Institute of Social Security, Toledo 21, Col. Juárez, Cuauhtémoc, 06600, Mexico City, Mexico.
authors: Selene
authors: S
authors: Konik-Comonfort
authors: Division of Technical Studies, Coordination of Economic Benefits, Mexican Institute of Social Security, Toledo 21, Col. Juárez, Cuauhtémoc, 06600, Mexico City, Mexico.
authors: Oliver
authors: O
authors: Macías-Pérez
authors: Health Information Division, Mexican Institute of Social Security, Durango 289, Col. Roma Norte, Cuauhtémoc, 06700, Mexico City, Mexico.
authors: Ángel
authors: Á
authors: Campos-Hernández
authors: Division of Information Services for Economic and Social Benefits, Mexican Institute of Social Security, Tokio 80, Col. Juárez, Cuauhtémoc, 06600, Mexico City, Mexico.
authors: Héctor
authors: H
authors: Rodríguez-Vázquez
authors: Division of Rehabilitation, Mexican Institute of Social Security, Durango 289, Col. Roma Norte, Cuauhtémoc, 06700, Mexico City, Mexico.
authors: Verónica Miriam
authors: VM
authors: López-Roldán
authors: Occupational Health Coordination, Mexican Institute of Social Security, Av. Cuauhtémoc 330, Col. Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
authors: Edgar Jesús
authors: EJ
authors: Zitle-García
authors: Occupational Health Coordination, Mexican Institute of Social Security, Av. Cuauhtémoc 330, Col. Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
authors: María Del Carmen
authors: Mdel C
authors: Solís-Cruz
authors: Occupational Health Coordination, Mexican Institute of Social Security, Av. Cuauhtémoc 330, Col. Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
authors: Ismael
authors: I
authors: Velázquez-Ramírez
authors: Occupational Health Coordination, Mexican Institute of Social Security, Av. Cuauhtémoc 330, Col. Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
authors: Miriam
authors: M
authors: Aguilar-Jiménez
authors: University of California, San Diego Extension, 8950 Villa La Jolla Drive, Suite C-215, La Jolla, California, 92093-0170, USA.
authors: Leonel
authors: L
authors: Villa-Caballero
authors: Epidemiological Surveillance Coordination, Mexican Institute of Social Security, Mier y Pesado 120, Col. del Valle, Benito Juárez, 03100, Mexico City, Mexico. nelly.cisneros@imss.gob.mx.
authors: Nelly
authors: 0000-0003-4507-0654
authors: N
authors: Cisneros-González
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012737:Sex Factors; D015996:Survival Rate; D014942:Workers' Compensation / Q000191:economics* / Q000706:statistics & numerical data*
keywords: Diabetes mellitus; Disability insurance; Survival