OBJECTIVES: Developed a novel method to estimate the expected loss of lifetime employment durations and earnings for end-stage kidney disease (ESKD) patients undergoing dialysis.

METHODS: Multiplying the lifetime survival function with a second function, this research estimates the lifetime employment duration (LED) and lifetime productivity. The data of survival function of ESKD patients and age-, sex-, and calendar year matched referents and were collected from the national health insurance claim data and national life table in Taiwan, respectively. The second function is the mean conditional employment to population ratio (EMRATIO) function or the mean monthly real wage of the index cohorts and the corresponding matched referents. Using the index cohort’s lifetime survival and referents’ lifetime employment probability, this research further extrapolates the EMRATIO function and earnings function of the ESKD patients. We calculate the difference in LED and productivities of ESKD patients and age-, sex- and calendar year-matched referents and obtain ESKD patients’ loss on lifetime LED and lifetime productivities.

RESULTS: The ESKD cohort was stratified by sex and age, for the seven age strata, 25-34, 35-40, 41-45, 46-50, 51-55, 56-60, and 61-64 years. Estimating results present that ESKD patients lost about 25-56% LED as well as about 32-66% lifetime productivity through adjustments for different age, sex, and calendar year. The older the ESKD patient, the less lifetime productivity was lost.

CONCLUSIONS: This article seems to be the first to quantify the productivity loss of a major chronic disease resulted from “presenteeism”, indicating that the affected patients would be unable to perform a job with their full capacity after the development of major complication of the disease. The loss of lifetime productivity would be a combined loss of LED because of increased premature mortality and functional disability and the loss related to presenteeism implied by the reduced wages.