title: Lost Productivity in Stroke Survivors: An Econometrics Analysis.
abstract: Stroke leads to a substantial societal economic burden. Loss of productivity among stroke survivors is a significant contributor to the indirect costs associated with stroke. We aimed to characterize productivity and factors associated with employability in stroke survivors.
  
  
  
  We used the Canadian Community Health Survey 2011-2012 to identify stroke survivors and employment status. We used multivariable logistic models to determine the impact of stroke on employment and on factors associated with employability, and used Heckman models to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages).
  
  
  
  We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted OR 0.39, 95% CI 0.33-0.46) and had hourly wages 17.5% (95% CI 7.7-23.7) lower compared to the general population, although there was no association between work hours and being a stroke survivor. We found that factors like older age, not being married, and having medical comorbidities were associated with lower odds of employment in stroke survivors in our sample.
  
  
  
  Stroke survivors are less likely to be employed and they earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies targeting return to work could be considered to address this lost productivity among stroke survivors.
authors.affiliation: Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Manav V
authors.initials: MV
authors.lastname: Vyas
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Hackam
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: Audrey
authors.initials: A
authors.lastname: Laporte
authors.forename: Moira K
authors.initials: MK
authors.lastname: Kapral
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D020521:Stroke / Q000191:economics*; D017741:Survivors; D014937:Work / Q000706:statistics & numerical data; D055815:Young Adult