Inpatient and outpatient rehabilitation for patients with rheumatoid arthritis: a clinical and economic assessment

Summary

The aim of this study was to compare inpatient and outpatient rehabilitation for patients with active rheumatoid arthritis from clinical and cost perspectives.

A single-centre, randomised trial design was used. Data were recorded at baseline, post treatment and at 6 months follow-up. The primary outcome measure was the Arthritis Impact Measurement Scale 2. Several other disease activity, functional and quality of life measures were also assessed (erythrocyte sedimentation rate, C-reactive protein, visual analogue scale for pain, early morning stiffness, tender and swollen joint count, grip strength, timed ‘Up and Go’ test and Schedule for the Evaluation of the Individual Quality of Life—Direct Weighting). All direct and indirect costs were measured. A total of 47 subjects were randomised to the study.

No sustained significant differences were detected between the two groups for the primary or secondary measures at the end of treatment or at follow-up. Total inpatient costs (€81,590) were more than three times higher than total outpatient costs (€25,450).

Keywords: :

• rheumatoid arthritis
• rehabilitation
• inpatient
• outpatient
• costs

Notes

* American College of Rheumatology classification of global functional status in RA: Class I, completely able to perform usual activities of daily living (self-care, vocational and avocational); Class II, able to perform usual self-care and vocational activities, but limited in avocational activities; Class III, able to perform usual self-care activities, but limited in vocational and avocational activities; and Class IV, limited in ability to perform usual self-care, vocational and avocational activities.