HEALTH-CARE UTILIZATION IN MULTIPLE-SCLEROSIS - A POPULATION-BASED STUDY IN OLMSTED COUNTY, MN

Objective: The authors sought to determine acute ambulatory-and hospit al-billed charges for the Olmsted County, Minnesota Multiple Sclerosis (MS) Disability Prevalence Cohort and compare them to those incurred by the general population. Methods: Billed charges for 155 people with clinically definite or laboratory-supported MS were compared with tho se of age-and gender-matched non-MS controls. Billing data, including all inpatient and outpatient acute and rehabilitative medical care cha rges over a 5-year period surrounding a December 1, 1991 prevalence da te, were analyzed. Data were correlated with level of disability using the Minimal Record of Disability for MS. Results: Median total annual billed charges for most individuals with MS, including those with les s severe ($1,277) and relapsing-remitting illness ($1,348), did not di ffer from those for controls ($1,327, p = 0.075). Only those with seve re MS (22.6%) had median annual medical charges higher than controls ( $5,440, p < 0.001). Male patients with MS had higher median annual tot al charges ($2,353) than male controls ($762, p = 0.003). Total charge s for female patients with MS ($1,440) were not different from those f or female controls ($1469). Median annual outpatient charges were 15% more for the MS group ($1,418) than for controls ($1,231). Patients wi th MS had a mean of 0.2 hospital admissions annually compared with 0.1 annual admissions per control patient. Among variables collected on p ersons with MS, the Expanded Disability Status Scale was the strongest predictor of level of charges (p < 0.001). Conclusion: Acute ambulato ry-and hospital-billed charges for most patients with MS do not differ from those of the general population.