Doherty E, O'Neill C
Centre for Pain Research and J.E. Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland.
J Public Health (Oxf). 2014 Sep;36(3):504-10. doi: 10.1093/pubmed/fdt097. Epub 2013 Oct 3.
An ageing population leads to increasing prevalence of age-related chronic conditions that present challenges to the health-care services. Despite this, in countries including Ireland, little is known about the health-care impact of conditions such as osteoarthritis or rheumatoid arthritis amongst older adults.
A series of count models are developed to investigate the incremental health-care usage of individuals with either osteoarthritis or rheumatoid arthritis on the use of general practitioners (GP) services, outpatients' services, accident and emergency visits and inpatient nights.
Both types of arthritic conditions lead to increased usage of GP and outpatients' services but not other hospital services. Differences in entitlements to care, as captured by the presence of a medical card in Ireland, lead to different health-care usage among arthritis sufferers. Translating the additional utilization into cost suggests a combined incremental annual cost of both types of arthritis of €13.6 million.
Osteoarthritis and rheumatoid arthritis present challenges to health-care services in the context of an ageing population. In the case of Ireland the burden falls predominantly on primary health-care and outpatient services. Within the context of changing health-care service provision in Ireland, the results of this study have implications for future planning of service delivery.
人口老龄化导致与年龄相关的慢性病患病率上升，这给医疗服务带来了挑战。尽管如此，在包括爱尔兰在内的国家，对于骨关节炎或类风湿关节炎等疾病对老年人的医疗影响知之甚少。
开发了一系列计数模型，以研究骨关节炎或类风湿关节炎患者在使用全科医生（GP）服务、门诊服务、急诊就诊和住院天数方面的增量医疗使用情况。
两种类型的关节炎都会导致全科医生和门诊服务使用量增加，但不会导致其他医院服务使用量增加。在爱尔兰，医疗卡的存在所反映的护理资格差异导致关节炎患者的医疗使用情况不同。将额外的使用量转化为成本表明，两种类型关节炎的年增量成本合计为1360万欧元。
在人口老龄化的背景下，骨关节炎和类风湿关节炎给医疗服务带来了挑战。就爱尔兰而言，负担主要落在初级医疗和门诊服务上。在爱尔兰医疗服务提供不断变化的背景下，本研究结果对未来服务提供规划具有启示意义。
