Follow-up costs up to 5 years after conventional treatments in patients with cartilage lesions of the knee.

In this retrospective cross-sectional study, we contacted patients who had been diagnosed with (and, if necessary, treated for) knee cartilage defects by arthroscopy at one of seven treatment centres in Germany between 1997 and 2001. In early 2003, patients completed a questionnaire on the health care resources they had used since the time of the arthroscopy. Based on this information, we determined follow-up costs. Data from a total of 1,708 patients were included in the final analysis. Of these, 1,070 were assigned to the initial operation (IO) group (61% men, 49+/-15 years; 39% women, 52+/-14 years) and 638 were assigned to the re-operation (RO) group (64% men, 44+/-13 years; 36% women, 47+/-14 years). The cumulative direct medical costs caused by knee complaints for the first 5 years following the arthroscopy were 1,984 Euro for the IO population and 4,203 Euro for the RO population. The cumulative indirect costs (i.e. costs associated with loss of productivity), however, amounted to 7,669 Euro and 15,265 Euro, respectively, and were thus almost four times as high as the cumulative direct costs. This is the first study that quantifies the considerable follow-up costs in patients who have undergone surgery for knee cartilage defects. As such, it may provide a yardstick for future treatments.

Costs of a healthy diet: analysis from the UK Women's Cohort Study.

OBJECTIVE: To investigate the direct and indirect cost differences associated with eating a 'healthy' or 'unhealthy' diet. DESIGN: Analysis of data from a baseline postal questionnaire for the UK Women's Cohort Study, including a detailed food frequency questionnaire (FFQ), supplemented by a telephone interview on a sub-sample. SUBJECTS: The first 15,191 women who responded to the questionnaire, aged 35-69 years with similar numbers of meat eaters, fish eaters and vegetarians. RESULTS: A healthy diet indicator (hdi), with values from 0 (lowest) to 8 (highest) was developed based on the WHO dietary recommendations. Direct monetary cost of the diet was calculated using prices from the 1995 National Food Survey and the Tesco home shopping catalogue. Women in the healthy diet group were almost four times as likely to be vegetarian and have a higher educational level. For direct costs, the difference between the most extreme hdi groups was 1.48 day-1 (equivalent to 540 year-1), with fruit and vegetable expenditure being the main items making a healthy diet more expensive. Forty-nine per cent of the food budget was spent on fruit and vegetables in hdi group 8 compared to 29% in hdi group 0. Interestingly, 52% of those questioned in both extreme hdi groups did not think that it was difficult to eat healthily. CONCLUSIONS: To achieve a particularly healthy diet independent predictive factors were spending more money, being a vegetarian, having a higher energy intake, having a lower body mass index (BMI) and being older.