title: Direct and indirect costs of osteoarthritis in Singapore: a comparative study among multiethnic Asian patients with osteoarthritis.
abstract: OBJECTIVE
  To estimate and compare the direct and indirect costs of osteoarthritis (OA) in multiethnic Asian patients with OA in Singapore.
  
  
  METHODS
  The study was a retrospective and cross-sectional design. Patients were stratified according to ethnicity and presence or absence of joint surgery. Direct costs were estimated from both a societal and a patient perspective using the Singapore General Hospital database; indirect costs were estimated using the human capital approach. All costs were expressed as mean costs per patient per annum in 2003 Singapore dollars.
  
  
  RESULTS
  A total of 1179 patients (83.6% Chinese, 7.2% Malay, 3.5% Indian, 5.7% others) were included in estimating direct costs, of which 513 (43.5%) had total knee replacement (TKR) and 92 (7.8%) total hip replacement (THR), while 105 patients (71.4% Chinese, 14.3% Malay, 14.3% Indian) were included in estimating indirect costs. Direct costs to patients ranged from 1460 dollars to 7477 dollars for Chinese, 1362 dollars-7211 dollars for Malays, 1688 dollars-6226 dollars for Indians, and 1437 dollars-12,140 dollars for other ethnic patients; direct costs to society ranged from 3351 dollars to 15,799 dollars for Chinese, 2939 dollars-15,436 dollars for Malays, 3150 dollars-10,990 dollars for Indians, and 2597 dollars-17,879 dollars for other ethnic patients. In contrast, the indirect costs ranged from 1215 dollars to 3834 dollars for Chinese, 1138 dollars-6116 dollars for Malays, and 1371 dollars-5292 dollars for Indians. However, most ethnic variations were not statistically significant.
  
  
  CONCLUSIONS
  The economic burden of OA to society and patients increased by 3-fold or more in the patients with TKR/THR compared to those without. The ethnic differences in health resources consumed were more apparent when the disease progressed.
authors.affiliation: Centre for Health Services Research, Yong Loo Lin School of Medicine, Department of Pharmacy, National University of Singapore, Republic of Singapore.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
authors.forename: Kok-Yong
authors.initials: KY
authors.lastname: Fong
authors.forename: Ngai-Nung
authors.initials: NN
authors.lastname: Lo
authors.forename: Seng-Jin
authors.initials: SJ
authors.lastname: Yeo
authors.forename: Kuang-Ying
authors.initials: KY
authors.lastname: Yang
authors.forename: Shu-Chuen
authors.initials: SC
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002681:China / Q000208:ethnology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000191:economics* / Q000453:epidemiology / Q000208:ethnology*; D012044:Regression Analysis; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology / Q000208:ethnology