title: Societal costs of rheumatoid arthritis in Hong Kong: a prevalence-based cost-of-illness study.
abstract: OBJECTIVE
  To estimate the direct and indirect costs among a cohort of Chinese patients with RA in Hong Kong.
  
  
  METHODS
  A cost-of-illness study using cross-sectional and retrospective data was conducted on 144 patients with RA. Costs were estimated from the societal perspective. Participants completed questionnaires regarding demographics, employment status and out-of-pocket expenses. Health resources consumption was recorded by review of medical records. Functional disability was assessed using the HAQ score.
  
  
  RESULTS
  The cohort had a mean age of 49 years and mean disease duration of 10.8 years. Average total costs of RA were estimated at $9286 (2006 US dollars) per patient-year, >60% of which was attributable to indirect costs due to productivity losses. Patients' out-of-pocket expenses and costs of inpatient care dominated direct costs, each representing 11% of total direct costs. Younger age, poorer physical and mental health independently predicted high direct costs. Older age, lower education level and more functional disability independently predicted high indirect costs.
  
  
  CONCLUSIONS
  RA is associated with both high direct and indirect costs, imposing a considerable economic burden on patients and society. The hope is that effort will be gathered not only from patients and physicians, but more importantly from government, to improve the care and treatment of patients with RA and to help reduce or avoid the considerable societal costs of RA.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006723:Hong Kong; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018582:Sick Leave / Q000191:economics; D012959:Socioeconomic Factors