Spaetgens Bart, Wijnands José M A, van Durme Caroline, van der Linden Sjef, Boonen Annelies
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Care and Public Health Research Institute (CAPHRI), University Maastricht, Maastricht, the Netherlands; and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman, Liège, Belgium.B. Spaetgens, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; J.M.A. Wijnands, MSc; S. van der Linden, MD, PhD; A. Boonen MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and CAPHRI Research Institute, University Maastricht; C. van Durme, MD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Département de Rhumatologie, Centre Hospitalier Universitaire du Sart-Tilman.
J Rheumatol. 2015 Feb;42(2):335-44. doi: 10.3899/jrheum.140679. Epub 2014 Nov 15.
To estimate costs of illness in a cross-sectional cohort of patients with gout attending an outpatient rheumatology clinic, and to evaluate which factors contribute to higher costs.
Altogether, 126 patients with gout were clinically assessed. They completed a series of questionnaires. Health resource use was collected using a self-report questionnaire that was cross-checked with the electronic patient file. Productivity loss was assessed by the Work Productivity and Activity Impairment Questionnaire, addressing absenteeism and presenteeism. Resource use and productivity loss were valued by real costs, and annual costs per patient were calculated. Factors contributing to incurring costs above the median were explored using logistic univariable and multivariable regression analysis.
Mean (median) annual direct costs of gout were €5647 (€1148) per patient. Total costs increased to €6914 (€1279) or €10,894 (€1840) per patient per year when adding cost for absenteeism or both absenteeism and presenteeism, respectively. Factors independently associated with high direct and high indirect costs were a positive history of cardiovascular disease, functional limitations, and female sex. In addition, pain, gout concerns, and unmet gout treatment needs were associated with high direct costs.
The direct and indirect costs-of-illness of gout are primarily associated with cardiovascular disease, functional limitations, and female sex.
评估在门诊风湿病诊所就诊的痛风患者横断面队列中的疾病成本，并评估哪些因素会导致更高的成本。
总共对126例痛风患者进行了临床评估。他们完成了一系列问卷调查。使用自我报告问卷收集卫生资源使用情况，并与电子病历进行交叉核对。通过工作效率和活动障碍问卷评估生产力损失，该问卷涉及旷工和出勤主义。资源使用和生产力损失按实际成本估值，并计算每位患者的年度成本。使用逻辑单变量和多变量回归分析探讨导致成本高于中位数的因素。
痛风患者的平均（中位数）年度直接成本为每位患者5647欧元（1148欧元）。分别加上旷工成本或旷工和出勤主义两者的成本后，总成本分别增至每位患者每年6914欧元（1279欧元）或10894欧元（1840欧元）。与高直接成本和高间接成本独立相关的因素是心血管疾病阳性史、功能受限和女性性别。此外，疼痛、痛风相关问题和未满足的痛风治疗需求与高直接成本相关。
痛风的直接和间接疾病成本主要与心血管疾病、功能受限和女性性别相关。
