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.
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).


CONCLUSIONS
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.
Ethgen
Olivier
O
Department of Public Health and Epidemiology, University of Liege, Belgium.
Kahler
Kristijan H
KH
Kong
Sheldon X
SX
Reginster
Jean-Yves
JY
Wolfe
Frederick
F
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010003:Osteoarthritis / Q000503:physiopathology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D011336:Probability; D011788:Quality of Life; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States
D018501:Antirheumatic Agents