Factors associated with healthcare costs in women with fibromyalgia

Objective: To examine how women with high and low healthcare costs differ b y using the Anderson Health Behavior Model of Utilization as a theoretical framework. Study Design: One-year longitudinal design. Patients and Methods: A total of 537 female health maintenance organization members with fibromyalgia participating in a study examining the effects o f social support and education on health status and healthcare use were div ided into 2 groups using a median split on health costs. Predisposing varia bles (demographic variables, self-efficacy, depression, and social support) , enabling characteristics (income), and need variables, (health status, pe rceived health status, disease severity, duration of symptoms, and comorbid ity) were measured. Patients completed a battery of questionnaires at basel ine assessment, and healthcare casts were assessed 1 year before and 1 year after baseline assessment. Healthcare data were collected from medical rec ords, Healthcare costs were estimated by multiplying the number of each typ e of healthcare contact by the most recent national average cost figure's. Results: Multivariate analysis of covariance controlling for costs during t he year before baseline assessment was performed. Low-cost patients had few er comorbid conditions, better health status, higher self-perceived health status, less disease severity, greater self-efficacy for functioning, lower depression scores, and higher social support scores. chi (2) Analyses reve aled no significant differences between groups on marital status but a sign ificant difference in income: low-cost patients were more likely to report higher incomes. Conclusions: There were several significant differences between people with higher and lower healthcare costs. Although effect sizes were small, many variables may be responsive to intervention.