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Embargoed for Release at 6:15 pm
ET , Sunday Oct. 17, 2004
Arthritis News
ARTHRITIS PATIENTS SPEND TWICE
AS MANY HEALTH CARE DOLLARS
SAN ANTONIO, TEXAS – The expenses for medical care for those
with arthritis are at least double the amount spent by those
without this debilitating disease, according to research presented
this week at the American College of Rheumatology Annual Scientific
Meeting in San Antonio, Texas.
Researchers recently utilized results from the 1999-2000 Medical
Expenditure Panel Survey (MEPS) to track expenditures for patients
with arthritis within a national sample of 4,176 individuals,
age 45 years and older. MEPS had followed these individuals for
two years, collecting information about chronic diseases including
arthritis, demographics, and functional limitations in daily
living such as walking, dressing, bending and grasping. The health
care expenditures monitored included office and hospital-based
care, home health care, dental services, vision aids, other medical
equipment and services, and prescribed medicines. To determine
which expenses were related to arthritis, researchers examined
three questions: 1) Do persons with arthritis have higher expenditures
than those without? 2) Does arthritis results in increased costs
after adjusting for differences in age, race, and gender, economics
and the presence of other chronic conditions? 3) What contributes
to high arthritis expenditures?
Data tabulated from these questions demonstrated that total
health care expenditures for persons with arthritis are at least
doubled when compared to the general population for all levels
of expenditures examined. Even after adjusting for age, race,
gender, other health conditions and economic status, expenditures
for those with arthritis remained at least 1.5 times higher.
The greatest factor contributing to the higher costs for arthritis
sufferers was found to be limitations in daily activities. These
functional limitations were experienced by two in every five
respondents, more than three times the frequency of limitations
among persons without arthritis.
“Arthritis-related functional limitation is a major contributor
to high U.S. health care costs,” said Orit Almagor, MA, Northwestern
University, Institute for Health Services Research and Policy
Studies, Chicago, Illinois, and an investigator
in the study. “Public health and clinical approaches that prevent
and treat arthritis and preserve daily activities in persons
with arthritis should be pursued for both potential cost savings
and improved quality of life for patients.”
The American College of Rheumatology is the professional organization
for rheumatologists and health professionals who share a dedication
to healing, preventing disability and curing arthritis and related
rheumatic and musculoskeletal diseases. For more information
on the ACR's annual meeting, see www.rheumatology.org/annual.
###
Editor's Note: Mr. Almagor will present this research during
a scientific session at the ACR Annual Scientific Meeting from
12:15 – 2:00 pm CT (1:15 – 3:00pm ET) on Wednesday, October
20, in Exhibit Hall C-D of the Henry B. Gonzalez
Convention Center.
Presentation Number: 1301
The Distribution of Health Care Expenditures: Comparison
between Persons with and without Arthritis
Orit Almagor, Larry M. Manheim, Rowland W. Chang, Dorothy D.
Dunlop. Northwestern University, Chicago, IL
Purpose. Examine the distribution of health
care expenditures for persons with and without arthritis and
factors that contribute to added expenditures due to arthritis,
using a nationally representative sample.
Methods. The 1999-2000 Medical Expenditure
Panel Survey (MEPS) is used to obtain a nationally representative
sample of 4,176 individuals age forty-five years and older.
The MEPS survey followed those individuals for two years.
Baseline (1999) self-reported information includes demographics,
function limitations, and chronic diseases including arthritis,
as defined by the National Arthritis Data Workgroup. Self-reported
total health care expenditures (sum of office and hospital-based
care, home health care, dental services, vision aids, other
medical equipment and services, and prescribed medicines)
and concurrent insurance status were obtained from the second
year (2000). We examined three questions: 1) Do persons with
arthritis have higher expenditures than those without? 2)
Does arthritis cost more after controlling for differences
in demographics, economics and comorbid chronic conditions?
3) What baseline factors contribute to high arthritis expenditures?
Total health care expenditures were described over a spectrum
of low to high expenditures: 10th, 25th, 50th (median), 75th,
and 90th percentiles. Quantile regression at each percentile
compared health care expenditures between persons with and
without arthritis. Logistic regression examined what factors
predict high expenditures among persons with arthritis.
Results. Total health care expenditures
for persons with arthritis are at least doubled compared
to persons without for all levels of expenditures examined.
Expenditures for persons with arthritis remain at least
1.5 times higher after adjusting for demographics, health
conditions, and economics status compared to their counterparts
without arthritis. Among persons with arthritis, functional
limitation is consistently the strongest factor predicting
high expenditures (above the 90 th percentile).
Conclusions. These data provide a nationally representative
estimate of the distribution of medical expenditures among persons with
and without arthritis. Total expenditures among persons with arthritis
are over 1.5 times greater compared to counterparts without arthritis
controlling for risk factors across a spectrum of low to high expenditures.
Functional limitation is the strongest predictor of high health care
expenditures among people with arthritis.
Disclosure: O. Almagor, NIAMS 2; L.M.
Manheim, NIAMS 2; R.W. Chang, NIAMS
2; D.D. Dunlop, NIAMS 2.
