Supplementary Material for: Lost Productivity in Stroke Survivors: An Econometrics Analysis

Background: 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. Methods: 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). Results: 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. Conclusions: 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.背景：脑卒中（Stroke）会造成沉重的社会经济负担，而卒中幸存者的生产力损失是卒中相关间接成本的重要组成部分。本研究旨在刻画卒中幸存者的生产力特征，并明确与其就业能力相关的影响因素。 方法：本研究依托2011-2012年加拿大社区健康调查（Canadian Community Health Survey）数据集，筛选卒中幸存者并采集其就业状态信息。通过多变量logistic回归模型分析卒中对就业及就业能力相关因素的影响，并采用赫克曼（Heckman）模型估算卒中对生产力的作用，具体指标包括每周工作时长与时薪。 结果：本研究共纳入18至70岁的91633名受访者，其中筛选出923名卒中幸存者，占比1%。相较于普通人群，卒中幸存者的就业概率显著更低（校正优势比（adjusted OR）=0.39，95%置信区间（95% CI）：0.33-0.46），时薪较普通人群低17.5%（95%置信区间（95% CI）：7.7-23.7）；不过卒中幸存者的每周工作时长与普通人群并无显著关联。本研究样本分析显示，年龄偏大、未婚以及存在合并症等因素，与卒中幸存者更低的就业优势比显著相关。 结论：卒中幸存者的就业概率显著低于普通人群，且时薪水平更低。可考虑开展针对性的职业康复干预，并制定助力卒中幸存者重返工作岗位的相关政策，以改善其生产力损失问题。