A 6-year trend of the healthcare costs of arthritis in a population-based cohort of older women

Abstract

Objective: To provide an accurate representation of the economic burden of arthritis by estimating the adjusted incremental healthcare cost of arthritis at multiple percentiles and reporting the cost trends across time. Methods: A healthcare cost study based on health survey and linked administrative data, where costs were estimated from the government's perspective in dollars per person per year. Quantile regression was used to estimate the adjusted incremental cost at the 25th, 50th, 75th, 90th, and 95th percentiles. Results: Data from 4287 older Australian women were included. The median incremental healthcare cost of arthritis was, in 2012 Australian dollars, $480 (95% CI: $498–759) in 2009; however, 5% of individuals had 5-times higher costs than the ‘average individual’ with arthritis. Healthcare cost of arthritis did not increase significantly from 2003 to 2009. Conclusion: Healthcare cost of arthritis represents a substantial burden for the governments. Future research should continue to monitor the economic burden of arthritis.

Keywords:

• arthritis
• Australia
• claims database
• economic burden
• healthcare costs
• quantile regression

Acknowledgments

The authors are grateful to the Australian Government Department of Health for funding, to the staff of ALSWH, and to the women who provided the survey data. We acknowledge the Department of Health and Medicare Australia for providing the PBS and MBS data. We acknowledge the Australian Institute of Health and Welfare (AIHW) as the integrating authority for these data. We also acknowledge the assistance of the Data Linkage Unit at the Australian Institute of Health and Welfare (AIHW) for undertaking the data linkage to the National Death Index (NDI). Researchers in the Research Centre for Gender, Health and Ageing at the University of Newcastle are members of the Hunter Medical Research Institute (HMRI), Newcastle.

Financial & competing interests statement

TKT Lo was supported by the University of Newcastle International Postgraduate Research Scholarship and the University of Newcastle Research Scholarship Central student scholarship. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Arthritis is associated with a substantial economic burden.

• While the generalized linear models have been commonly used to estimate the mean incremental cost of arthritis, quantile regression can be used to estimate the cost at any quantile.

• Few cost studies have examined the trends of the cost of arthritis over time.

• In 2009, the mean adjusted incremental healthcare cost of arthritis in older Australian women was estimated at (2012 Australian dollars) $503 per person per year, while the 25th, 50th, 75th, 90th, and 95th percentiles were $334, 480, 1049, 1564, and 2516, respectively.

• Results also show that there was no statistically significant increase in the adjusted incremental healthcare cost of arthritis between 2003 and 2009.

• Information about the cost distribution in individuals with arthritis and the cost trends can be very useful for health policy. It is recommended that future research report the cost at multiple quantiles and continue to monitor the cost of arthritis over time.