Social security burden due to work-related disability due to kidney failure
Main Article Content
Keywords
Work Disability, Disabilities, Pension, Kidney Failure, Mexico
Abstract
Background: Kidney Failure (KF) leads to loss of productive years, premature mortality, and substantial social burden due to work-related disability.
Objective: To characterize temporary and permanent work disability transfers attributable to KF among affiliates of the Mexican Social Security Institute (IMSS).
Methods: Patterns of use were analyzed for: (a) disability pensions at the national and regional levels, and (b) temporary work disability (TWD) at the healthcare facility level. All monetary values are expressed in 2024 Mexican pesos (MXN).
Results: A decreasing trend in newly granted KF-related disability pensions was identified over time. In 2024, 690 new pensions were reported, 24% of which were for women, with the highest proportions in Jalisco (26%) and the State of Mexico (14%). Temporary work disability was observed in 24% of insured individuals who ultimately returned to work, lasting on average 70 days (SD 71) and costing MXN 11,534 (SD 12,347). Individuals on automated peritoneal dialysis had shorter TWD durations (p < 0.05). Among new pension recipients, 88% had a preceding TWD episode lasting an average of 95 days (95% CI: 82–112), equivalent to MXN 16,102 (95% CI: 12,866–18,339). The estimated average annual pension, weighted by salary range, was MXN 74,218. On average, 17.4 productive years (95% CI: 16–19) and 27.3 years lived with disability were lost per case.
Conclusions: Standardizing IMSS procedures aimed at assessing and mitigating work disability could substantially reduce the burden of KF for patients, their families, and society.
References
1. Tonelli M, Lloyd A, Cheung WY, et.al. Mortality and Resource Use Among Individuals With Chronic Kidney Disease or Cancer in Alberta, Canada, 2004-2015. JAMA Netw Open. 2022;5(1):e2144713. doi: 10.1001/jamanetworkopen.2021.44713
2. Ripari NV, Elorza ME, Moscoso NS. Costos de enfermedades: una revisión crítica de las metodologías de estimación. Lecturas de Economía. 72012; 77: 253-282. Disponible en: https://www.redalyc.org/pdf/1552/155226077008.pdf
3. Essue BM, Wong G, Chapman J, et.al. How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study. BMC Nephrol. 2013;14:5. doi: 10.1186/1471-2369-14-5
4. Valdez-Ortiz R, Navarro-Reynoso F, Olvera-Soto MG, et al. Mortality in Patients With Chronic Renal Disease Without Health Insurance in Mexico: Opportunities for a National Renal Health Policy. Kidney Int Rep. 2018;3(5):1171-82. doi: 10.1016/j.ekir.2018.06.004
5. Instituto Mexicano del Seguro Social. Informe al Ejecutivo Federal y al Congreso de la Unión sobre la situación financiera y los riesgos del Instituto Mexicano del Seguro Social, 2023–2024. Ciudad de México: IMSS; 2024. Disponible en: https://www.imss.gob.mx/conoce-al-imss/informes.
6. Instituto Mexicano del Seguro Social. Archivo Memorias estadísticas del IMSS. 2024. [base de datos]. Ciudad de México: IMSS; 2024. Disponible en: https://www.imss.gob.mx/conoce-al-imss/memoria-estadistica-2024
7. Torres-Toledano M, Granados-García V, Cortés-Sanabria L, et.al. Service Utilization Patterns and Direct Medical Costs of Hospitalization in Patients With Renal Failure Before and After Initiating Home Peritoneal Dialysis. Value in Health Regional Issues. 2024;41:114-22. doi: https://doi.org/10.1016/j.vhri.2023.12.004.
8. Instituto Mexicano del Seguro Social. Norma 3000-001 para determinar el estado de invalidez. Ciudad de México: IMSS; 2018 [actualizada el 30 de nov 2018]. Disponible en: https://www.imss.gob.mx/sites/all/statics/pdf/manualesynormas/3000-001-022.pdf
9. Congreso de los Estados Unidos Mexicanos. Ley del Seguro Social [Internet]. Diario Oficial de la Federación, Ciudad de México; última reforma publicada el 25 de abril de 2023. Disponible en: https://www.diputados.gob.mx/LeyesBiblio/pdf/LSS.pdf
10. Juárez OJ. Invalidez y Vida. Boletin Comisión Representativa Ante Organismos de Seguridad Social. 2023. Disponible en: https://imcp.org.mx/wp-content/uploads/2023/03/CROSS-Inform-2023-04.pdf
11. Martinez-Marín BM, Haro-Acosta ME, Quiñones Montelongo KA, e.al. Costes de invalidez por insuficiencia renal crónica en la Delegación Baja California del Instituto Mexicano del Seguro Social. Medicina y Seguridad del Trabajo. 2017;63:120-30. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0465-546X2017000200120
12. Olinca P. Esperanza de vida sin limitaciones físicas ni mentales en México. Realidad, datos y espacio revista internacional de estadística y geografía. INEGI. México. 2022;13.
13. Crews DC, Bello AK, Saadi G. Burden, access, and disparities in kidney disease. J Nephrol. 2019;32(1):1-8. doi: 10.1007/s40620-019-00590-6
14. Vasquez-Jimenez E, Madero M. Global Dialysis Perspective: Mexico. Kidney360. 2020;1(6):534-7. doi: 10.34067/KID.0000912020
15. Agudelo-Botero M, González-Robledo MC, Reyes-Morales H, et. al. Health care trajectories and barriers to treatment for patients with end-stage renal disease without health insurance in Mexico: a mixed methods approach. Int J Equity Health. 2020;19(1):90. doi: 10.1186/s12939-020-01205-4
16. Xie C, Wu Q, Xie C, Shi Z. Social determinants of health and chronic kidney disease in United States adults: A cross-sectional study from National Health and Nutrition Examination Survey 2003–2018. Preventive Medicine Reports. 2025;55:103132. doi: 10.1016/j.pmedr.2025.103132
17. Aguilar F, Molina RE, Amozurrutia JA, et.al. Healthcare equity and chronic renal failure in Mexico: an analysis for the case of women. Medwave. 2019;19(3):e7619. doi: 10.5867/medwave.2019.03.7619
18. Balsells E. La enfermedad renal crónica de causa no tradicional (ERCnT): una visión desde la protección social y la economía preventiva. Ciencia, Tecnología y Salud. 2020;7. doi: 10.36829/63CTS.v7i1.896
19. Bay SS, Kamaruzaman L, Mohd R, et.al. Work disability and employment status among advanced chronic kidney disease patients. PLoS One. 2024;19(3):e0297378. doi: 10.1371/journal.pone.0297378
20. Turchetti G, Bellelli S, Amato M, et al. The social cost of chronic kidney disease in Italy. Eur J Health Econ. 2017;18(7):847-58. DOI: 10.1007/s10198-016-0830-1
21. Kamal-Bahl SJ, Pantely S, Pyenson B, e.al. Employer-paid nonmedical costs for patients with diabetes and end-stage renal disease. Prev Chronic Dis. 2006;3(3):A83. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16776884/
22. Instituto Mexicano del Seguro Social. Guías de duración de la incapacidad por patología, en apoyo a la prescripción de la incapacidad temporal para el trabajo. Ciudad de México: IMSS.
23. Álvarez-Blázquez, Carbajo S, Terradillos MJ, V, et.al. Guía de Valoración de Incapacidad Laboral para Médicos de Atención Primaria”. Escuela Nacional de Medicina del Trabajo (ENMT). Escuela Nacional de Medicina del Trabajo (ENMT) Instituto de Salud Carlos III Ministerio de Ciencia e Innovación Madrid. 2009. https://amat.es/wp-content/uploads/2021/03/guia-de-valoracion-de-incapacidad-temporal-para-medicos-de-atencion-primaria.pdf
24. Brown EA, Zhao J, McCullough K, et al. Burden of Kidney Disease, Health-Related Quality of Life, and Employment Among Patients Receiving Peritoneal Dialysis and In-Center Hemodialysis: Findings From the DOPPS Program. Am J Kidney Dis. 2021;78(4):489-500.e1. doi: 10.1053/j.ajkd.2021.02.327
25. Alma MA, van der Mei SF, Brouwer S, et al. Sustained employment, work disability and work functioning in CKD patients: a cross-sectional survey study. J Nephrol. 2023;36(3):731-43. doi: 10.1007/s40620-022-01476-w
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.