Lapsley H M, March L M, Tribe K L, Cross M J, Brooks P M
School of Health Services Management, University of New South Wales, Sydney, Australia.
Arthritis Rheum. 2001 Jun;45(3):301-6. doi: 10.1002/1529-0131(200106)45:3<301::AID-ART264>3.0.CO;2-I.
To determine "out-of-pocket" expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants.
A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded.
Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness.
Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.
确定与骨关节炎（OA）相关的“自付费用”，并探讨人口统计学细节、健康状况评分（医学结局研究简明健康调查问卷36项量表[SF - 36]和西安大略和麦克马斯特大学骨关节炎指数[WOMAC]）或社会影响认知是否为费用决定因素。
对社区居住的OA患者进行一项前瞻性队列研究，患者连续4个3个月完成费用日记。此外，患者在基线和12个月时完成SF - 36和WOMAC。收集基线时的社会影响。比较按年龄和性别分类的四组。排除接受关节置换的患者。
健康状况差异更多由年龄而非性别决定，尤其是身体功能方面。患者费用较高，尤其是女性，她们在药物和特殊设备上花费更多。女性还报告从家人和朋友那里得到更多帮助。与疾病相关的较高支出与更高的疼痛水平、较差的社会功能和心理健康以及更长的病程相关。与OA相关的患者总支出的显著独立预测因素是女性和关节僵硬。
尽管澳大利亚的医疗保健有大量补贴且可享受药品福利计划，但OA患者的自付费用仍相当可观。OA患者较高的支出与更严重的疾病相关，尤其是女性。
