139 lines
4.4 KiB
YAML
139 lines
4.4 KiB
YAML
abstract: 'Objective. With increasing interest in revising the mechanisms of health
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care funding, the ability to anticipate patients'' medical expenditures
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as well as to identify potentially modifiable predictors would be
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informative for health care providers, payers, and policy makers.
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Methods. Eight hundred fifty-eight patients with rheumatoid arthritis
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from 2 Canadian centers reported semi-annually on their health services
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utilization and health status for up to 12 years. Annual direct costs
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were calculated using 1993 Canadian prices. Regression models for the
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variation in total direct costs and the individual resource components
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(i.e., physicians, tests, medications, acute and non-acute hospital
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care) were estimated using previous values of age, sex, disease
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duration, education, methotrexate availability, employment status,
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global well being, pain, duration of morning stiffness, and functional
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disability as predictor variables. The models were developed using all
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available data except the last 2 observations (i.e., data collected on
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the last 2 self-report questionnaires) from each patient, which were
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reserved for model validation. The predictive abilities of the models
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were assessed by comparing the most recent costs with those predicted by
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the model using values of the predictor variables from the previous time
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period. Further, to assess whether the models conferred any advantage
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over cost estimates based only on previous costs, most recent observed
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costs were also compared with costs observed in the preceding time
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period.
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Results. Self-reported indices of either global well being, pain, or
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functional disability predicted total direct costs as well as the costs
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of the 5 individual resource components. Being younger, female, disabled
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from the work force, having shorter disease duration, and receiving more
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formal education also predicted higher costs in at least on health
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resource category. However, being older predicted higher acute and
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non-acute care hospital costs. Regression models incorporating
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longitudinal data did not perform better than average costs in the
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preceding rime period in predicting future short term costs.
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Conclusion. Global well being, pain, functional disability, and previous
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costs are the most important predictors of short term direct medical
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costs. Although we have demonstrated that regression models do not
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perform better than previous costs in predicting future short term
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costs, previous costs are a much less informative predictor than health
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status variables. Variables such as functional disability and pain
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identify potentially modifiable disease features and suggest
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interventions that may improve patient well being and reduce costs.'
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affiliation: 'Clarke, AE (Corresponding Author), McGill Univ, Montreal Gen Hosp, Dept
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Med, Div Clin Epidemiol, 1650 Cedar Ave, Montreal, PQ H3G 1A4, Canada.
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McGill Univ, Montreal Gen Hosp, Dept Med, Div Clin Epidemiol, Montreal, PQ H3G 1A4,
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Canada.
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McGill Univ, Montreal Gen Hosp, Dept Med, Div Clin Immunol Allergy, Montreal, PQ
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H3G 1A4, Canada.
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McGill Univ, Montreal Gen Hosp, Dept Med, Div Internal Med, Montreal, PQ H3G 1A4,
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Canada.
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Univ Saskatchewan, Dept Med, Div Rheumatol, Saskatoon, SK S7N 0W0, Canada.
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Univ British Columbia, Mary Pack Arthrit Ctr, Dept Med, Div Rheumatol, Vancouver,
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BC, Canada.'
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author: Clarke, AE and Levinton, C and Joseph, L and Penrod, S and Zowall, H and Sibley,
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JT and Grover, SA and Esdaile, JM
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author_list:
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- family: Clarke
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given: AE
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- family: Levinton
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given: C
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- family: Joseph
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given: L
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- family: Penrod
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given: S
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- family: Zowall
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given: H
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- family: Sibley
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given: JT
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- family: Grover
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given: SA
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- family: Esdaile
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given: JM
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da: '2023-09-28'
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files: []
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issn: 0315-162X
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journal: JOURNAL OF RHEUMATOLOGY
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keywords: rheumatoid arthritis; health care costs; disability; predictors
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keywords-plus: 'SYSTEMIC LUPUS-ERYTHEMATOSUS; MUSCULOSKELETAL DISORDERS; DISABILITY;
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OUTCOMES; IMPACT'
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language: English
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month: MAY
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number: '5'
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number-of-cited-references: '24'
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pages: 1068-1075
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papis_id: 79e811417748b77e334935b021219f82
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ref: Clarke1999predictingshort
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times-cited: '37'
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title: Predicting the short term direct medical costs incurred by patients with rheumatoid
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arthritis
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type: Article
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unique-id: WOS:000080003200011
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '26'
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web-of-science-categories: Rheumatology
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year: '1999'
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