The effect of health related quality of life on reported use of health care resources in patients with osteoarthritis and rheumatoid arthritis: a longitudinal analysis

• Published in: Journal of rheumatology Vol. 29; no. 6; pp. 1147 - 1155
• Main Authors: ETHGEN, Olivier, KAHLER, Kristijan H, KONG, Sheldon X, REGINSTER, Jean-Yves, WOLFE, Frederick
• Format: Journal Article Web Resource
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-06-2002; Journal of Rheumatology Publishing; Journal of Rheumatology Publishing Company
• Subjects: Activities of Daily Living; Adaptation, Physiological; Adaptation, Psychological; Aged; Antirheumatic Agents - administration & dosage; Arthritis, Rheumatoid - physiopathology; Arthritis, Rheumatoid - therapy; Arthritis, Rheumatoid/physiopathology/therapy; Biological and medical sciences; Combined Modality Therapy; Confidence Intervals; Diseases of the osteoarticular system; Female; General & internal medicine; Health Resources - utilization; Hospitalization - statistics & numerical data; Human health sciences; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Médecine générale & interne; Office Visits - statistics & numerical data; Osteoarthritis - physiopathology; Osteoarthritis - therapy; Osteoarthritis/physiopathology/therapy; Patient Acceptance of Health Care - statistics & numerical data; Physical Therapy Modalities; Probability; Quality of Life; Questionnaires; Sciences de la santé humaine; Sensitivity and Specificity; Severity of Illness Index; Sickness Impact Profile; Surveys and Questionnaires; United States; United States; Human; Immunopathology; Evaluation; Prognosis; Questionnaire; Methodology; Diseases of the osteoarticular system; Autoimmune disease; Inflammatory joint disease; Health service; Test reliability; Epidemiology; Quality of life; Symptomatology; Validity; Chronic; Treatment; Follow up study; Rheumatoid arthritis; Arthropathy; Degenerative disease; Predictive factor; Osteoarthritis
• ISSN: 0315-162X; 1499-2752; 1499-2752

OBJECTIVE: In today's cost conscious environment, health services researchers are consistently trying to find ways to predict
future health care resource utilization (HCRU) and its associated costs. We evaluated the impact of health related quality
of life (HRQL) on future HCRU in patients with arthritis. METHODS: A total of 642 patients with rheumatoid arthritis (RA)
and 395 patients with osteoarthritis (OA) completed at least 2 and as many as 6 consecutive surveys at 6 mo intervals. Information
collected included demographics, HRQL questionnaires [Medical Outcome Study Short Form 36 (SF-36), Western Ontario McMaster
Universities Osteoarthritis Index (WOMAC), and the Stanford Health Assessment Questionnaire (HAQ)], and HCRU over the previous
6 months. Longitudinal data analysis was perfomed to assess the effect of HRQL on future HCRU. RESULTS: Statistically significant
associations between HCRU and HRQL variables were noted. Higher rates of HCRU were found in those in the worst quarter compared
with those in the best quarter of HRQL. With the HAQ, OA and RA patients in the worst quarter reported a 199% (p < 0.05) and
48% (p < 0.05) increase in rheumatologist visits, respectively. With the WOMAC Function, increases were as high as 196% (p
< 0.05) in rheumatologist visits for patients with OA. Patients with RA with a high level of HRQL as measured by the SF-36
(physical component score) reported a decrease of 31% (p < 0.01) in general practitioner visits and a decrease of 52% (p <
0.01) in hospitalization (mental component score). CONCLUSION: These findings suggest that HRQL may be used to predict future
health care consumption. Such an approach may lead to a more efficient allocation of resources by providing useful information
to health care providers and health care decision makers.