St Vincent's Clinical School, UNSW Sydney, Sydney, NSW, Australia.
Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, NSW, Australia.
Int J Rheum Dis. 2021 Mar;24(3):327-334. doi: 10.1111/1756-185X.13979. Epub 2020 Sep 25.
To measure the direct and indirect out-of-pocket (OOP) costs borne by Australians with gout.
A cross-sectional, Australia-wide, web-based survey was conducted over 12 months between May 2017 and April 2018. Participants were recruited via advertisements in doctors' clinics and healthcare organizations' websites, and social media platforms such as Facebook and Twitter. Survey questions collected information about participants' OOP spending on direct medical and non-medical gout-related healthcare costs. Participant demographics, gout status, healthcare sought, workdays lost to due gout and health-related quality of life were also collected.
Seventy-nine patients with gout completed the survey; 70 (89%) were male, and on average were 56 (SD 16) years of age and had gout for 14 (SD 12) years. For this cohort, the median total OOP direct medical cost was AU$200 per year (interquartile range [IQR]: AU$60-AU$570). Sixty (76%) people with gout reported being affected by gout during work; however, only 0.25 (IQR: 0-3) days of work (approximately $60) were lost due to gout in a year. Nine percent (n = 7) of participants experienced cost-related treatment attrition and 33% reported economic hardship (n = 26). Participants who experienced economic hardship or cost-related treatment attrition had higher median total gout-related direct costs than those who did not.
In Australia, gout has an OOP financial cost and reduces work productivity. The presence of cost-related treatment attrition among people with gout indicates that financial costs may be a significant barrier to seeking treatment for a subset of patients with gout.
衡量澳大利亚痛风患者的直接和间接自付（OOP）费用。
2017 年 5 月至 2018 年 4 月，进行了为期 12 个月的澳大利亚全国性、横断面、基于网络的调查。通过医生诊所和医疗机构网站以及 Facebook 和 Twitter 等社交媒体平台的广告招募参与者。调查问题收集了参与者在直接医疗和非医疗痛风相关医疗保健费用上的 OOP 支出信息。还收集了参与者的人口统计学资料、痛风状况、所寻求的医疗服务、因痛风而损失的工作日以及与健康相关的生活质量。
79 名痛风患者完成了调查；70 名（89%）为男性，平均年龄为 56（标准差 16）岁，痛风病史为 14（标准差 12）年。对于这一组，每年 OOP 直接医疗总费用中位数为 200 澳元（四分位距 [IQR]：60-570 澳元）。60（76%）名痛风患者报告在工作期间受到痛风影响；然而，每年因痛风损失的工作时间仅为 0.25（IQR：0-3）天（约 60 澳元）。9%（n=7）的参与者经历了与费用相关的治疗中断，33%（n=26）报告经济困难。经历经济困难或与费用相关的治疗中断的参与者的总痛风相关直接费用中位数高于未经历的参与者。
在澳大利亚，痛风会产生 OOP 财务成本，并降低工作生产力。痛风患者中存在与费用相关的治疗中断表明，对一部分痛风患者而言，财务成本可能是寻求治疗的一个重要障碍。
