Vol.:(0123456789) 1 3
Digestive Diseases and Sciences
https://doi.org/10.1007/s10620-020-06646-z
ORIGINAL ARTICLE
Prevalence, Indirect Costs, and Risk Factors for Work Disability
in Patients with Crohn’s Disease at a Tertiary Care Center in Rio de
Janeiro
Renata de Sá Brito Fróes
1,2
· André da Luz Moreira
3,4
· Antonio José de V. Carneiro
5
· Jessica P. L. Moreira
6
·
Ronir R. Luiz
6
· Adriana Maria Hilu de Barros Moreira
2
· Camila Cesar Monnerat
2
· Heitor Sifert Pereira de Souza
4,5
·
Ana Teresa Pugas Carvalho
1
Received: 30 June 2020 / Accepted: 28 September 2020
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Background and Aims Crohn’s disease (CD) can lead to work disability with social and economic impacts worldwide. In
Brazil, where its prevalence is increasing, we assessed the indirect costs, prevalence, and risk factors for work disability in
the state of Rio de Janeiro and in a tertiary care referral center of the state.
Methods Data were retrieved from the database of the Single System of Social Security Benefts Information, with a cross-
check for aid pension and disability retirement. A subanalysis was performed with CD patients followed up at the tertiary
care referral center using a prospective CD database, including clinical variables assessed as possible risk factors for work
disability.
Results From 2010 to 2018, the estimated prevalence of CD was 26.05 per 100,000 inhabitants, while the associated work
disability was 16.6%, with indirect costs of US$ 8,562,195.86. Permanent disability occurred more frequently in those aged
40 to 49 years. In the referral center, the prevalence of work disability was 16.7%, with a mean interval of 3 years between
diagnosis and the frst beneft. Risk factors for absence from work were predominantly abdominal surgery, anovaginal fstulas,
disease duration, and the A2 profle of the Montreal classifcation.
Conclusions In Rio de Janeiro, work disability afects one-sixth of CD patients, and risk factors are associated with disease
duration and complications. In the context of increasing prevalence, as this disability compromises young patients after a
relatively short period of disease, the socioeconomic burden of CD is expected to increase in the future.
Keywords Infammatory bowel disease · Crohn’s disease · Work disability · Disease pension · Indirect costs · Productivity
loss
Abbreviations
IBD Infammatory bowel disease
CD Crohn’s disease
INSS National Institute of Social Security
SUIBE Unifed Benefts Information System
Electronic Supplementary Material The online version of this
article (https://doi.org/10.1007/s10620-020-06646-z) contains
supplementary material, which is available to authorized users.
* Heitor Sifert Pereira de Souza
heitor.souza@gmail.com; hsouza@hucf.ufrj.br
1
Disciplina de Gastroenterologia e Endoscopia Digestiva,
Universidade do Estado do Rio de Janeiro, Rio de Janeiro,
RJ 20551-900, Brazil
2
Perícia Médica Federal (PMF), Superintendência Regional
9 da Subsecretaria de PMF do Ministério da Economia,
Rio de Janeiro, RJ 20030-030, Brazil
3
Disciplina de Proctologia, Universidade do Estado do Rio de
Janeiro, Rio de Janeiro, RJ 20551-900, Brazil
4
D’Or Institute for Research and Education (IDOR), Rua
Diniz Cordeiro 30, Botafogo, Rio de Janeiro, RJ 22281-100,
Brazil
5
Serviço de Gastroenterologia, Departamento de Clínica
Médica, Hospital Universitário Clementino Fraga Filho,
Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho
Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro,
RJ 21941-913, Brazil
6
Instituto de Estudos de Saúde Coletiva (IESC), Universidade
Federal do Rio de Janeiro, Rio de Janeiro 21944-970, Brazil