Living with osteoarthritis: Patient expenditures, health status, and social impact

Objective. To determine "out-of-pocket" expenditures related to osteoarthri tis (OA) and to explore whether demographic details, health status scores ( Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and M cMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects complet ed the SF-36 and WOMAC at baseline and at 12 months. Social impact at basel ine was collected. Four groups categorized by age and sex were compared. Pa tients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, par ticularly for women, who spent more on medications and special equipment. W omen also reported receiving more assistance from family and friends. Highe r disease-related expenditures were associated with greater pain levels, po orer social function and mental health, and longer duration of disease. Sig nificant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA i n Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.