Subject(s)
Arthritis, Rheumatoid/diet therapy , Diabetes Mellitus, Type 2/diet therapy , Fatty Acids, Omega-3/pharmacology , Inflammatory Bowel Diseases/diet therapy , Kidney Diseases/diet therapy , Lupus Erythematosus, Systemic/diet therapy , Metabolic Syndrome/diet therapy , Osteoporosis/diet therapy , Adrenal Cortex Hormones/therapeutic use , Adult , Anti-Inflammatory Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Bone Density , Child , Diabetes Mellitus, Type 2/metabolism , Fatty Acids, Omega-3/physiology , Fatty Acids, Omega-3/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Inflammatory Bowel Diseases/drug therapy , Kidney Diseases/drug therapy , Meta-Analysis as Topic , Metabolic Syndrome/metabolism , Placebos , Randomized Controlled Trials as TopicABSTRACT
OBJECTIVE: To compare the economic burden to society incurred by patients with RA, OA, or high blood pressure (HBP) in Ontario, Canada. METHODS: Consecutive subjects recruited by 52 rheumatologists (RA) and 76 family physicians (OA and HBP) were interviewed at baseline and 3 months. Information was collected on demographics, health status, and any comorbidities. A detailed, open ended resource utilisation questionnaire inquired about the use of medical and non-medical resources and patient and care giver losses of time and related expenses. Annual costs were derived as recommended by national costing guidelines and converted to American dollars (year 2000). Statistical comparisons were made using ordinary least squares regression on raw and log transformed costs, and generalised linear modelling with adjustment for age, sex, educational attainment, and presence of comorbidities. RESULTS: Baseline and 3 month interviews were completed by 253/292 (86.6%) patients with RA and 473/585 (80.9%) patients with OA and/or HBP. Baseline and total annual disease costs for RA (n = 253), OA and HBP (n = 191), OA (n = 140), and HBP (n = 142), respectively, were $9300, $4900, $5700, and US$3900. Indirect costs related to RA were up to five times higher than indirect costs incurred by patients with OA or HBP, or both. The presence of comorbidities was associated with disease costs for all diagnoses, cancelling out potential effects of age or sex. CONCLUSION: The economic burden incurred by RA significantly exceeds that related to OA and HBP, while differences between patients with a diagnosis of OA without HBP or a diagnosis of HBP alone were non-significant, largely owing to the influence of comorbidities.
Subject(s)
Arthritis, Rheumatoid/economics , Cost of Illness , Health Care Costs , Hypertension/economics , Osteoarthritis/economics , Aged , Arthritis, Rheumatoid/diagnosis , Caregivers/economics , Employment/economics , Female , Humans , Hypertension/diagnosis , Male , Middle Aged , Osteoarthritis/diagnosis , Osteoarthritis, Hip/economics , Osteoarthritis, Knee/economics , Patient Acceptance of Health Care , Surveys and QuestionnairesABSTRACT
SUMMARY: The purpose of this study was to compare prospectively the distributions, validity, and discriminative ability of three pediatric outcome questionnaires. Consecutive patients completed the Activities Scales for Kids (ASK), the Child Health Questionnaire Parent Form (CHQ-PF-28), and the Pediatrics Outcomes Data Collection Instrument (PODCI). The scores of the three instruments were compared with each other and with parents' and clinicians' ratings. Of 210 patients, 166 (79%) completed the three questionnaires. The CHQ-PF-28 had a different distribution than the other two questionnaires and showed both floor and ceiling effects. The ASK and PODCI instruments were highly correlated and discriminated better than the CHQ-PF-28, with fewer floor and ceiling effects. Each questionnaire, however, seemed to be measuring slightly different things.