DIRECT MEDICAL COSTS UNIQUE TO PEOPLE WITH ARTHRITIS

Objective. We report the results of a population based analysis of all health services used and charges incurred over a one-year period amon g a community based cohort of persons with a diagnosis of arthritis [i ncluding both osteoarthritis (OA) and rheumatoid arthritis (RA)] compa red to a similar cohort of individuals from the same community who hav e never had a diagnosis of arthritis (NA), to examine the attributable costs of this chronic condition. Methods. The unique resources of the Rochester Epidemiology Project were used to assemble the arthritis pr evalence cohorts and the population based control cohort. The Olmsted County Health Care Utilization and Expenditures Database was used to c ollect information on health services utilization and charges. Results . The average direct medical charges for the RA, OA, and NA cohorts we re $3,802.05, $2,654.51, and $1,387.83, respectively (age and sex adju sted, p < 0.0001 for both the RA vs NA and OA vs NA comparisons). The median charges for these 3 groups were $1,050.00, $663.55, and $232.04 for the RA, OA, and NA groups, respectively (age and sex adjusted p < 0.0001 for both the RA vs NA and OA vs NA comparisons). These analyse s indicated that, compared to the NA cohort, both the OA and the RA pr evalence cohorts incurred statistically significantly more charges, no t only for the musculoskeletal disease care, but also for the care of numerous other conditions including respiratory, cardiovascular, gastr ointestinal, neurological, and psychiatric conditions; and for general medical care. Individuals with arthritis (both OA and RA) also incurr ed statistically significantly more charges for diagnostic and therape utic procedures, in-hospital care, imaging studies, physician services , equipment, and laboratory studies. Use of prescription medications w as statistically significantly more common in the RA and OA groups com pared to WA (96.3, 96, and 83% respectively; age and sex adjusted p = 0.006 for the OA vs NA comparison and p = 0.015 for RA vs NA). (C)oncl usion. These results emphasize the importance of considering all healt h services utilization (rather than only disease specific use) when es timating the economic effect of a chronic illness such as arthritis.