Gupta S, Hawker G A, Laporte A, Croxford R, Coyte P C
Department of Heath Policy, Management and Evaluation, 2nd Floor McMurrich Building, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
Rheumatology (Oxford). 2005 Dec;44(12):1531-7. doi: 10.1093/rheumatology/kei049. Epub 2005 Aug 9.
To estimate the direct and indirect arthritis-attributable costs to individuals with disabling hip and/or knee osteoarthritis (OA).
An established population cohort with disabling hip and/or knee OA from two regions of Ontario, Canada was surveyed to determine participant and caregiver costs related to OA, and the predictors of these costs.
The response rate was 87.2%. Of 1378 respondents, 1258 had OA (mean age 73.1 yr, range 59-100). Sixty per cent (n = 758) reported OA-related costs. Among these individuals, the average annual cost was 12,200 dollars(CDN dollars in 2002, where 1.00 CDN dollar approximately 0.81 US dollar). Time lost from employment and leisure by participants and their unpaid caregivers accounted for 80% of the total. Men were less likely than women to report costs (adjusted odds ratio 0.54, P < 0.0001), but when they did their expenditures were significantly higher (P = 0.004). Greater disability was associated with higher costs: compared with individuals with WOMAC total scores <15, those with scores > or = 55 were 15 times more likely to report costs, and their costs were 3 times greater (both P < 0.0001). Both the young (<65 yr) and very old were more likely to incur costs (P < 0.0001), and when they did their costs were higher (P < 0.001).
Costs incurred were mainly for time lost from employment and leisure, and for unpaid informal caregivers. Failure to value such indirect costs significantly underestimates the true burden of OA. Costs increased with worsening health status and greater OA severity. After adjustment, men were less likely to incur costs, possibly due to greater social resources.
评估致残性髋部和/或膝部骨关节炎（OA）患者因关节炎产生的直接和间接费用。
对来自加拿大安大略省两个地区的既定致残性髋部和/或膝部OA人群队列进行调查，以确定与OA相关的参与者和照料者费用，以及这些费用的预测因素。
应答率为87.2%。在1378名受访者中，1258人患有OA（平均年龄73.1岁，范围59 - 100岁）。60%（n = 758）报告了与OA相关的费用。在这些个体中，平均年度费用为12,200加元（2002年加元，1.00加元约等于0.81美元）。参与者及其无薪照料者在就业和休闲方面损失的时间占总费用的80%。男性报告费用的可能性低于女性（调整后的优势比为0.54，P < 0.0001），但当他们报告费用时，支出显著更高（P = 0.004）。残疾程度越高，费用越高：与WOMAC总分<15的个体相比，总分>或 = 55的个体报告费用的可能性高15倍，且费用高出3倍（P均< 0.0001）。年轻人（<65岁）和老年人产生费用的可能性都更高（P < 0.0001），且当他们产生费用时，费用更高（P < 0.001）。
产生的费用主要用于就业和休闲时间的损失以及无薪非正式照料者。未对这些间接费用进行评估会显著低估OA的真实负担。费用随着健康状况恶化和OA严重程度增加而增加。调整后，男性产生费用的可能性较小，可能是由于社会资源更多。
