1. Allaire, S. H., DeNardo, B. S., Szer, I. S., Meenan, R. F., and Schaller, J. G. The economic impacts of juvenile rheumatoid arthritis. J.Rheumatol. 19(6), 952-955. 1992.
Floating Hospital for Infants and Children, Department of Pediatrics, Tufts University School of Medicine, Boston, MA
Keywords: Arthritis/Infant/Questionnaires/Human/Support,U.S.Gov't,P.H.S./Arthritis,Juvenile Rheumatoid economics/Adolescence/Arthritis,Juvenile Rheumatoid epidemiology/Child/Child,Preschool/Costs and Cost Analysis/New England,Epidemiology,EP/juvenile rheumatoid arthritis/rheumatoid arthritis/Pediatrics/Schools/Boston/Canada/Family/New England/England/questionnaire/AND/School/CHILDREN/JUVENILE/RHEUMATOID/RHEUMATOID-ARTHRITIS/CRITERIA/All/Cost of Illness
Notes: Our study documents the direct costs, family costs and community (extra school) costs. One hundred and twenty families with children who had juvenile rheumatoid arthritis (JRA) diagnosed by established criteria and who lived in New England were asked to participate. All data except inpatient charged were collected via questionnaire. The questionnaire return rate was 59% (N = 70). The mean annualized direct cost/child was 7,905 (inpatient, $1, 717; outpatient, $5,700; and nonmedical, $488). Family costs averaged $1,524/year (out of pocket medical and nonmedical, $1, 196; lost salary, $328), which represented 5% of mean family income. The mean extra school cost was $1,449/9 months. The economic impacts of JRA appear to be substantial
2. Lee, P. The economic impact of musculoskeletal disorders. Qual.Life Res. 3 Suppl 1, S85-91. 1994.
Wellesley Hospital, Toronto, Ontario, Canada
Keywords: Arthritis/Pain/United States/Human/Arthritis,Rheumatoid economics/Cost of Illness/Low Back Pain,Economics,EC/Arthritis,Juvenile Rheumatoid economics/Canada,Epidemiology,EP/Musculoskeletal Diseases,Economics,EC/Musculoskeletal Diseases,Epidemiology,EP/Canada/England/Morbidity/disability/rheumatoid arthritis/Statistics/Back Pain/TERM/LONG-TERM/AND/POPULATION/MEDICAL-CARE/from/RHEUMATOID/RHEUMATOID-ARTHRITIS/HEALTH/MANAGEMENT
Notes: Musculoskeletal disorders have a major impact on society in terms of morbidity, long-term disability and economics. As populations increase and age, payment for medical care and indirect costs from loss of earnings will increase. Both rheumatoid arthritis and low back pain have a great economic impact on society, and the costs of these are escalating problems. Statistics are analysed from various studies in the United States and Canada, and these highlight the need for more rational and effective health care management strategies
3. Miller, M. L. and White, P. H. Caring for indigent children with rheumatologic diseases. The challenge continues. Am.J.Dis.Child 147(5), 535-535. 1993.
Department of Pediatrics, Children's Memorial Hospital, Chicago, IL 60814-2025.
Keywords: Child/Medically Uninsured/United States/Arthritis,Juvenile Rheumatoid economics/Cost of Illness/Poverty/Disease
4. Pincus, T. The underestimated long term medical and economic consequences of rheumatoid arthritis. Drugs 50 Suppl 1, 1-14. 1995.
Keywords: Source MEDLINE/Anti-Inflammatory Agents,Non-Steroidal/Arthritis,Rheumatoid/Cause of Death/Cost of Illness/Female/Health Care Costs/Human/Male/Time Factors/LONG-TERM/TERM/AND/RHEUMATOID/rheumatoid arthritis/RHEUMATOID-ARTHRITIS/Arthritis/Disease/joint/Mortality/MEDICAL-CARE/disability/Role/Pain/helplessness/HEALTH/reimbursement/Adverse/Adverse Effects/effect/Therapy/Patients/PATIENT/ONSET/POPULATION/polyarthritis/WOMEN/MEN/knee/DRUGS/drug/Inflammation/TREATMENT/review/LITERATURE
Notes: Rheumatoid arthritis is generally a progressive disease, with radiographic evidence of joint damage, declines in functional status, and premature mortality. In addition, the disease has severe long term economic consequences, including direct costs of medical care, indirect costs of work disability and interference with social roles, as well as the intangible costs of pain, fatigue, helplessness, loss of self-efficacy, and other psychological difficulties. The consequences of rheumatoid arthritis have often been underestimated by health professionals, reimbursement agencies, the general public, and even rheumatologists. Furthermore, the adverse effects of potential therapies have often been regarded as more severe than the 'adverse effects' of untreated disease. More than 50% of patients with rheumatoid arthritis who are younger than 65 years and who were working at onset of disease receive work disability payments, and 0.8% of the US population eligible to work are individuals who have symmetrical polyarthritis but who, unfortunately, are not working. The total earnings gap between individuals with symmetrical arthritis and those in the general population was $US8.9 billion for women and $US8.7 billion for men, for a total of $US17.6 billion (1986 US dollars). The projected costs of knee replacement in patients with rheumatoid arthritis in the US are between $US600 million and $US900 million annually. New approaches to therapy, which include earlier and more aggressive intervention, new drugs, and combinations of drugs, appear required to provide adequate control of inflammation, so that the long term damage of rheumatoid arthritis might be prevented and the considerable costs ameliorated. The possible adverse effects and costs of treatment must be balanced against the adverse effects and underestimated costs of rheumatoid arthritis
Type: JOURNAL ARTICLE
Type: REVIEW
Type: REVIEW LITERATURE
5. Sangha, O. and Stucki, G. Economic impact of rheumatologic disorders [see comments]. Curr Opin Rheumatol 9(2), 102-105. 1997.
Keywords: Source MEDLINE/Canada/Cost of Illness/Great Britain/Health Care Costs/Health Care Rationing/Health Care Reform/Human/Managed Care Programs/Musculoskeletal Diseases/Rheumatic Diseases/United States/HEALTH/SYSTEM/AND/Movement/Rheumatology/musculoskeletal disease/DISEASES/Disease/Evaluation/review
Notes: Universally, health care systems are currently undergoing tremendous change. It is not sufficient to demonstrate that specific medical interventions and services are effective, as third party payers have become increasingly interested in financial outcomes. Managed care has accelerated this movement and rheumatology is facing new challenges to position itself in a changing health care environment. Studies dealing with the economic burden of musculoskeletal diseases and the economic evaluation of particular services and interventions are reviewed. As the health care system shifts toward managed care, rheumatology is facing tremendous challenges to position itself in new markets
Type: JOURNAL ARTICLE
Type: REVIEW
Type: REVIEW, TUTORIAL
6. Wilson, L. Cost-of-illness of scleroderma: the case for rare diseases [In Process Citation]. Semin.Arthritis Rheum. 27(2), 73-84. 1997.
School of Pharmacy, University of California, San Francisco 94143, USA
Keywords: Cost of Illness/scleroderma/Disease/connective tissue disease/Methods/Mortality/Morbidity/Human/Prevalence/United States/disease duration/Chronic Disease/Age of Onset/Schools/Chronic/CONNECTIVE/TISSUE/AND/DISEASES/Secondary/SENSITIVITY/Result/MODEL/ONSET/TREATMENT
Notes: OBJECTIVE: To determine the societal costs of scleroderma (SSc), a rare chronic connective tissue disease that affects approximately 98,000 Americans. Lack of reliable national databases limit rare disease cost studies, and this study suggests methods of using multiple data sources to assess the costs of rare diseases. METHODS: Primary and secondary data sources were used to calculate direct and indirect costs of SSc, including discounted lifetime mortality and morbidity costs. A prevalence-based, human capital approach was used. Sensitivity analyses were used to vary parameters that are uncertain, such as prevalence, mortality, and labor costs. RESULTS: Annual direct and indirect costs of SSc in the United States are $1.5 billion. Morbidity represents the major cost burden, with costs of $819 million (56%) of total costs. The current value of lifetime earnings lost was $179 million (12%) or $300,000 per death. Direct costs were $462 million (32%) or $4,731 per person annually, indicating that costs are spread over the long disease duration. CONCLUSIONS: This study provides one model for the assessment of rare disease costs. Triangulation of data sources and sensitivity analyses are important for determining the costs of rare diseases. The high cost of SSc, despite its low prevalence, suggests that the burden of rare chronic diseases can be high. The high morbidity costs reflect the young age of onset of the disease as well as the need for treatments to decrease morbidity costs. Local shared databases and national surveys are needed to improve cost estimates of rare diseases
7. Zitting, P. and Vanharanta, H. Why do we need more information about the risk factors of the musculoskeletal pain disorders in childhood and adolescence? Int.J.Circumpolar Health 57(2-3), 148-155. 1998.
Department of Public Health Science and General Practice, University of Oulu, Finland.
Keywords: Pain/Back Pain/Neck/Neck Pain/AND/shoulder/HEALTH/POPULATION/DISEASES/Disease/SYSTEM/Risk/Risk Factors/risk factor/CHILDHOOD/Adolescence/Finland/Cohort Studies/EARLY/Syndrome/Cost of Illness
Notes: Musculoskeletal pain disorders such as low back pain, neck pain and shoulder pain are a major and ever increasing public health problem among the working population in industrialized countries with social insurance. Especially the economic impact of these diseases on society has been rising, but the disorders do also produce a lot of pain and suffering to the people. It is an important challenge to the health care systems to prevent and treat these disorders, but at the moment poor understanding of the risk factors of these diseases has failed in giving any effective tools to control the musculoskeletal pain disorder epidemic. Most of the epidemiological studies made are cross-sectional and they do not extend to childhood and adolescence, when the organs are developing, achieving their loading strength and possibly being traumatized and starting their degenerative process. The longitudinal Northern Finland 1966 birth cohort study offers a unique opportunity to find early risk factors for muskuloskeletal pain syndromes.