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Appendix
METHODS: CHAPTER 3
We estimated indirect and inpatient health service delivery costs associated with digestive
diseases for 31 UEG member countries, for which data were available.
INDIRECT COSTS
An output-based approach, developed by Pandey et al.,125 was used to estimate the
economic cost of morbidity and premature mortality due to digestive diseases for 31
countries. This involved the estimation of output per worker and output per person for each
country included in the analysis.
Measures and data sources
Output per worker for each country in 2019 was calculated as the product of the labour
income share of GDP, GDP per person employed, and the ratio of workers to the population.
These data were obtained from ILOSTAT and World Bank databases (Table 17). Countryspecific
estimates of the monetary value of unpaid family domestic and childcare work,
produced by Giannelli, Mangiavacchi and Piccoli,162 were used to calculate non-market
output for those not in work. We used these country-specific estimates of unpaid household
labour where available, and used data on earnings and time spent on unpaid domestic and
care work to impute estimates for Bulgaria, Croatia, Israel, Montenegro, Norway, Romania,
Serbia, Switzerland and Turkey. Output estimates for those in and out of work were
combined to produce output per person. Output estimates were calculated for age groups in
five-year intervals, ranging from 15-84 years.
The expected output loss associated with digestive disease morbidity for persons of a given
age in 2019 was calculated as the product of output per person and years of healthy life lost
due to digestive disease related disability for that age. For premature mortality, the expected
output lost if a person died in 2019 was calculated as the present discounted value of their
future output. Output for each future age was weighted by the probability that a person
would have survived to that age and discounted at a rate of 3%. The expected output loss
associated with digestive disease related premature mortality in 2019 for persons of a given
age was thus calculated as the present discounted value of their future output multiplied by
the number of deaths due to digestive diseases for that age. Data on years of healthy life lost
due to disability, deaths and survival probabilities were obtained from GBD 2019.
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