雇用を失うリスクが高い冠動脈疾患の患者の特定. プロスペクティブな検証研究です
1Division of Cardiology, Duke University Medical Center, Durham, N.C. 27710.
Circulation
|November 1, 1992
まとめ
労働力から離脱するリスクが高い冠動脈疾患の患者は,医学的および非医学的要因を組み合わせたモデルを使用して特定することができます. リバスカライゼーションだけでは,職場復帰を保証できません.
科学分野:
- 心臓病学 心臓病学
- 職業衛生は,健康に関するものです.
- 健康経済学 医療経済学
背景:
- 労働障害は冠動脈疾患 (CAD) の患者で一般的であり,経済的福祉と生活の質に影響を及ぼします.
- CAD患者の早期労働力離脱を予測することは,標的を絞った介入にとって極めて重要です.
研究 の 目的:
- 冠動脈疾患の患者の早期労働力離脱に関する予測モデルを開発し,将来的に検証する.
主な方法:
- 65歳未満の1,252人の雇用されたCAD患者のコホートは,医療,機能,心理,経済,および仕事に関連する変数について評価されました.
- ロジスティック回帰は,独立したコホートで検証された多変数モデルを構築するために使用されました.
- 患者の就労状態を判断するために1年間追跡調査を行いました.
主要な成果:
- 8つの要因が独立して労働力の脱退を予測した:機能的地位の低下,高齢化,黒人人種,心不全,教育水準の低下,心血管外疾患,心理的地位の低下,職業分類の低下.
- 機能的,人口的,社会経済的指標は,標準的な臨床変数よりも情報提供性が高い.
- このモデルは,トレーニング (0.80) とテスト (0.74) の両方のサンプルで良好な予測精度を実証しました.
結論:
- 医学的および非医学的要因の組み合わせにより,早期労働力退出のリスクが高いCAD患者の正確な特定が可能になります.
- 開発されたモデルは,多次元介入プログラムから恩恵を受ける可能性のあるリスクのある個人を特定するためのツールとして機能します.
- 再血管化処置 (PTCAまたはCABG) だけでは,労働状態を維持するには不十分です.
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