Browsing by Author "Borges, M"
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- The burden of atherosclerosis in PortugalPublication . Costa, J; Alarcão, J; Araujo, F; Ascenção, R; Caldeira, D; Fiorentino, F; Gil, V; Gouveia, M; Lourenço, F; Mello E Silva, A; Sampaio, F; Vaz-Carneiro, A; Borges, MAims: This paper sought to estimate the burden of disease attributable to atherosclerosis in mainland Portugal in 2016. Methods and results: The burden of atherosclerosis was measured in disability-adjusted life years (DALY) following the latest 2010 Global Burden of Disease (GBD) methodology. DALYs were estimated as the sum of years of life lost (YLL) with years lived with disability (YLD). The following clinical manifestations of atherosclerosis were included: ischemic heart disease (IHD) (including acute myocardial infarction (AMI), stable angina, and ischemic heart failure (IHF)), ischemic cerebrovascular disease (ICVD) and peripheral arterial disease (PAD). YLL were estimated based on all-cause mortality data for the Portuguese population and mortality due to IHD, ICVD and PAD for the year 2016 sourced from national statistics. Standard life expectancy was sourced from the GBD study. YLD corresponded to the product of the number of prevalent cases by an average disability weight (DW) for all possible combinations of disease. Prevalence data for the different clinical manifestations of atherosclerosis were sourced from epidemiological studies. DW were sourced from the published literature. In 2016, 15,123 deaths were attributable to atherosclerosis, which corresponded to 14.3% of overall mortality in mainland Portugal. DALYs totaled 260,943, 75% due to premature death (196,438 YLL) and 25% due to disability (64,505 YLD). Conclusion: Atherosclerosis entails a high disease burden to society. A large part of this burden would be avoidable if evidence-based effective and cost-effective interventions targeting known risk factors, from prevention to treatment, were implemented.
- The impact on productivity costs of reducing unemployment in patients with advanced breast cancer: A model estimation based on a Portuguese nationwide observational studyPublication . Vasconcelos de Matos, L; Borges, M; Oliveira, AT; Bulhosa, C; Miguel, LS; Fidalgo de Freitas, T; Cunha, R; Mendes, AD; Arede, AJ; Marques, C; Costa, DA; Correia, JA; Brito, M; Fontes e Sousa, M; Guimarães, T; Cardoso, FThis study aimed to characterize the employment status and work-related conditions of patients with advanced breast cancer (ABC) in Portugal and quantify the productivity costs of premature abandonment of the work market while evaluating strategies to promote employment. The analysis was based on a cumulative incidence model for estimation of ABC prevalence and on a cross-sectional study characterizing the employment status of patients with ABC. This study was conducted in Portuguese hospitals, between Nov2021-Dec2022 and included patients diagnosed with ABC for at least 6 months, aged 66 or less and consenting for a self-answered questionnaire regarding work status. A total of 2151 working-aged women were estimated to have ABC in 2019 in Portugal, with productivity costs amounting to 28,676,754€ over 2019-2021. 112 patients from 9 hospitals were included in the study, average age was 52yr, 48 % had a postsecondary educational degree level and 87 % reported having a paid job at the time of diagnosis, mostly full-time. At the time of the study, only 38 % of the patients maintained the job status. The remaining were unemployed (51 %), on medical leave (25 %) or retired (24 %). Stop working was a personal choice for only 5 %. A subsidized part-time employment regimen, despite increased government costs, would allow a reduction in productivity costs, leading to a positive balance of 2,431,329€ over the same period. This study suggests that the majority of patients with ABC abandon the labor market before the age of retirement. Flexible work arrangements would benefit the patient, the government and the society.