憂鬱症對於實際勞動表現之影響： 以勞工保險殘廢給付之病人為例

Abstract

憂鬱症所造成的社會經濟負擔除了直接醫療所需花費，還有間接的損失，如請假與生產力下降的工作損失、死亡等。對於精神疾病所造成之能力缺損與生產力降低，目前在工作效率減低、工作穩定性不佳所造成收入的缺損、生病造成之升遷影響等因素，現有評估方式往往難以列入計算。本研究希望透過勞工於勞工保險投保之相關資料，來了解憂鬱症對於被保險人勞動力的影響。 本研究使用資料來源為為勞保局於95年度勞保局委託研究“勞工保險殘廢給付『精神障害』等級及審查標準之研究“所發表之民國94年10至12月核定精神障害類別之資料。採計量統計方法。分析憂鬱症之勞保被保險人與所有被保險人之年齡、性別、診斷與診斷代碼、殘廢等級、初診時間與殘廢申請時間、職業異動與投保薪資等變項差異 。 比較109位憂鬱症被保險人與母群體所有勞保被保險人之差異，申請勞保殘廢給付者其薪資（21754.86元新台幣/月）較所有勞保人薪資（27059.98）平均低5305.12元， 兩組間達顯著差異（t=5.4023, p<0.00001）。 憂鬱症勞工在工作年資中，工作投保單位變換平均為6.99次，工作變換率為0.58次/年，是一般勞工的三倍。憂鬱症通過殘廢給付之疾病時間為4.14年、通過組之疾病年-年資比為24.99%， 遠高於未通過組之2.75年（p < 0.05）。 由本研究結果得知憂鬱症病患其薪資的確較一般人為低，這表示憂鬱症並不是單純短期的一個疾病，它影響的範疇遠比我們想像中來的深遠。因此憂鬱症所造成的失能，不論是可見還是不可見，對於個人、家庭、企業，社會，甚至國家都有不可忽視的影響。

The depressive disorder made a lot of social economic burdens. The burdens include not only the direct cost – the medical cost, but also the indirect cost, such as the poor work efficiency, lower productivity, absenteeism, instability in work and death. It’s difficult to evaluate the all deficit values by the current methods. In this study, we use the data of the depressed workers for the impairment benefit payment of the labor insurance from the Oct to Dec in 2005. The study is compiled statistics by quantity. The items for statistics are the age, sex, disease names and codes, disability levels, duration of diseases, number of the job-change and the salary for the insurance. Among the 109 depressed workers, the average salary for insurance is 21754.86 NTD per month, which is significant lower than the average salary of total labors (p value < 0.00001). The job-change rate is 0.58 times per year which is 3 times than the healthy labors. The illness year is higher in the disable depressed worker than non-disable. The salaries of the depressed workers are lower than the healthy workers. This implicates that depressive disorders are not short term diseases. The impacts of depressive disorders are under estimated. It will be the important issue about the influence of depressive disorders in the families, business, and countries.