Employment benefits and job retention: evidence among patients with colorectal cancer

Christine M Veenstra, Paul Abrahamse, Todd H Wagner, Sarah T Hawley, Mousumi Banerjee, Arden M Morris, Christine M Veenstra, Paul Abrahamse, Todd H Wagner, Sarah T Hawley, Mousumi Banerjee, Arden M Morris

Abstract

A "health shock," that is, a large, unanticipated adverse health event, can have long-term financial implications for patients and their families. Colorectal cancer is the third most commonly diagnosed cancer among men and women and is an example of a specific health shock. We examined whether specific benefits (employer-based health insurance, paid sick leave, extended sick leave, unpaid time off, disability benefits) are associated with job retention after diagnosis and treatment of colorectal cancer. In 2011-14, we surveyed patients with Stage III colorectal cancer from two representative SEER registries. The final sample was 1301 patients (68% survey response rate). For this study, we excluded 735 respondents who were not employed and 20 with unknown employment status. The final analytic sample included 546 respondents. Job retention in the year following diagnosis was assessed, and multivariable logistic regression was used to evaluate associations between job retention and access to specific employment benefits. Employer-based health insurance (OR = 2.97; 95% CI = 1.56-6.01; P = 0.003) and paid sick leave (OR = 2.93; 95% CI = 1.23-6.98; P = 0.015) were significantly associated with job retention, after adjusting for sociodemographic, clinical, geographic, and job characteristics.

Keywords: Colorectal neoplasms; employment; health; insurance; sick leave; surveys and questionnaires.

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

References

    1. Sommers, B. D. , Gunja M. Z., Finegold K., and Musco T.. 2015. Changes in self‐reported insurance coverage, access to care, and health under the affordable care act. JAMA 314:366–374.
    1. Langa, K. M. , Fendrick A. M., Chernew M. E., Kabeto M. U., Paisley K. L., and Hayman J. A.. 2004. Out‐of‐pocket health‐care expenditures among older Americans with cancer. Value Health 7:186–194.
    1. Regenbogen, S. E. , Veenstra C. M., Hawley S. T., Banerjee M., Ward K. C., Kato I., et al. 2014. The personal financial burden of complications after colorectal cancer surgery. Cancer 120:3074–3081.
    1. Banegas, M. P. , Guy G. P. Jr, de Moor J. S., Ekwueme D. U., Virgo K. S., Kent E. E., et al. 2016. For working‐age cancer survivors, medical debt and bankruptcy create financial hardships. Health Aff. 35:54–61.
    1. Ramsey, S. , Blough D., Kirchhoff A., Kreizenbeck K., Fedorenko C., Snell K., et al. 2013. Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis. Health Aff. 32:1143–1152.
    1. Veenstra, C. M. , Regenbogen S. E., Hawley S. T., Abrahamse P., Banerjee M., and Morris A. M.. 2015. Association of paid sick leave with job retention and financial burden among working patients with colorectal cancer. JAMA 314:2688–2690.
    1. Waldfogel, J. , Higuchi Y., and Abe M.. 1999. Family leave policies and women's retention after childbirth: evidence from the United States, Britain, and Japan. J. Popul. Econ. 12:523–545.
    1. United States Department of Labor . Family and Medical Leave in 2012: Technical Report. Available at (accessed 3 May 2017.)
    1. National Partnership for Women & Families . Paid sick days: Attitudes and experiences. Available at (accessed 3 May 2017).
    1. Bradley, C. J. , Neumark D., and Barkowski S.. 2013. Does employer‐provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer. J. Health Econ. 32:833–849.
    1. Garcia‐Gomez, P. , van Kippersluis H., O'Donnell O., and van Doorslaer E.. 2013. Long term and spillover effects of health shocks on employment and income. J. Hum. Resour. 48:873–909.
    1. Bradley, C. J. , Neumark D., Motika M. I., and National Bureau of Economic Research . 2011. The effects of health shocks on employment and health insurance the role of employer‐provided health insurance. National Bureau of Economic Research, Cambridge, MA: Available at .
    1. Ihbe‐Heffinger, A. , Ehlken B., Bernard R., Berger K., Peschel C., Eichler H. G., et al. 2004. The impact of delayed chemotherapy‐induced nausea and vomiting on patients, health resource utilization and costs in German cancer centers. Ann. Oncol. 15:526–536.
    1. Siegel, R. L. , Miller K. D., Fedewa S. A., Ahnen D. J., Meester R. G., Barzi A., et al. 2017. Colorectal cancer statistics, 2017. CA Cancer J. Clin. 67:177–193.
    1. Bailey, C. E. , Hu C. Y., You Y. N., Bednarski B. K., Rodriguez‐Bigas M. A., Skibber J. M., et al. 2015. Increasing disparities in the age‐related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg. 150:17–22.
    1. Yabroff, K. R. , Dowling E. C., Guy G. P. Jr, Banegas M. P., Davidoff A., Han X., et al. 2016. Financial hardship associated with cancer in the United States: findings from a population‐based sample of adult cancer survivors. J. Clin. Oncol. 34:259–267.
    1. Veenstra, C. M. , Regenbogen S. E., Hawley S. T., Griggs J. J., Banerjee M., Kato I., et al. 2014. A composite measure of personal financial burden among patients with stage III colorectal cancer. Med. Care 52:957–962.
    1. Dillman, D. A. , Smyth J. D., Christian L. M., and Dillman D. A.. 2009. Internet, mail, and mixed‐mode surveys: the tailored design method, 3rd ed. Wiley & Sons, Hoboken, NJ.
    1. Chatterji, P. , Brandon P., and Markowitz S.. 2016. Job mobility among parents of children with chronic health conditions: early effects of the 2010 Affordable Care Act. J. Health Econ. 48:26–43.
    1. D'Agostino, R. B. Jr . 1998. Propensity score methods for bias reduction in the comparison of a treatment to a non‐randomized control group. Stat. Med. 17:2265–2281.
    1. Pryor, F . 2017. Occupational choices of the elderly. Monthly Labor Review, U.S. Bureau of Labor Statistics. Available at (accessed 2 November 2017).
    1. United States Department of Labor Bureau of Labor Statistics . Employee benefits survey 2016. Available at (accessed 3 May 2017).
    1. National Partnership for Women & Families . Paid sick days–State, District and County Statutes. Available at (accessed 3 May 2017).
    1. United States Department of Labor Wage and Hour Division (WHD) . Final rule: Executive Order 13706, establishing paid sick leave for federal contractors. Available at (accessed 3 May 2017).
    1. Houser, L. , and Vartanian T. P.. 2012. Pay matters: the positive economic impacts of paid family leave for families, businesses and the public. Rutgers Center for Women and Work, New Brunswick, NJ.
    1. Catalano, P. J. , Ayanian J. Z., Weeks J. C., Kahn K. L., Landrum M. B., Zaslavsky A. M., et al. 2013. Representativeness of participants in the cancer care outcomes research and surveillance consortium relative to the surveillance, epidemiology, and end results program. Med. Care 51:e9–e15.
    1. Blinder, V. , Patil S., Eberle C., Griggs J., and Maly R. C.. 2013. Early predictors of not returning to work in low‐income breast cancer survivors: a 5‐year longitudinal study. Breast Cancer Res. Treat. 140:407–416.
    1. Blinder, V. S. , Patil S., Thind A., Diamant A., Hudis C. A., Basch E., et al. 2012. Return to work in low‐income Latina and non‐Latina white breast cancer survivors: a 3‐year longitudinal study. Cancer 118:1664–1674.
    1. Short, P. F. , Vasey J. J., and Tunceli K.. 2005. Employment pathways in a large cohort of adult cancer survivors. Cancer 103:1292–1301.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel