Losses in productivity-adjusted life years before, during and after orthopedic surgeries in Finland

Abstract Background Musculoskeletal diseases requiring surgical procedures in working-age adults impose a significant financial burden on many societies. We evaluated seven most common elective orthopedic surgeries among the Finnish working-age employed population with an aim to quantify losses in productivity-adjusted life years (PALY) and assess the societal economic impact of PALY loss due to sickness absence. Methods Data from electronic health records from the Wellbeing Services County of Southwest Finland, Finland, in 2020-2022 compiled with information from national administrative registries were used to identify working-age, employed patients from seven disease groups (N = 770). PALY losses were estimated in the year before hospitalization, during the hospitalization, and in the year after hospitalization. The economic value of PALY losses was calculated in total and on a per-patient basis based on a reported national average value of one sickness absence day (€344). Results In all seven patient groups together, on average, 17.4 PALY (27.5% of total PALY loss) were annually lost (corresponding to €2,192,683) in the year before hospitalization, 1.0 (1.6%) PALY annually lost (€194,773) during the hospitalization, and 44.8 (70.9%) PALY annually lost (€5,619,243) in the year after hospitalization. The highest pre-operative per-patient PALY loss in monetary terms was among patients with lumbar spine fusion (€16,693) while the highest post-operative per-patient PALY loss in monetary terms occurred among patients with knee osteoarthritis and knee replacement (€28,673). Conclusions The PALY loss in monetary terms per-patient was higher in the post-operative period compared to the pre-operative period. The seven patient groups examined produced considerable PALY losses and related total economic value to the Wellbeing Services County of Southwest Finland. The results of the study call for actions to support a more rapid return to work. Key messages • Although most of the PALY losses over the periods occurred in post-procedural recovery, approximately one-quarter of the total PALY losses had already accumulated before the surgical procedures. • The public health impact of PALY losses is considerable in the studied region and the results call for studies on waiting lists for treatment and actions to support more rapid return to work.