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Direct and Indirect Costs of Osteoarthritis in Singapore: A Comparative Study Among Multiethnic Asian Patients with Osteoarthritis
FENG XIE, JULIAN THUMBOO, KOK-YONG FONG, NGAI-NUNG LO, SENG-JIN YEO, KUANG-YING YANG, and SHU-CHUEN LI 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 to $7477 for Chinese, $1362–$7211 for Malays, $1688–$6226 for Indians, and $1437–$12,140 for other ethnic patients; direct costs to society ranged from $3351 to $15,799 for Chinese, $2939–$15,436 for Malays, $3150–$10,990 for Indians, and $2597–$17,879 for other ethnic patients. In contrast, the indirect costs ranged from $1215 to $3834 for Chinese, $1138–$6116 for Malays, and $1371–$5292 for Indians. However, most ethnic variations were not statistically significant. Conclusion. 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. (J Rheumatol 2007;34:165–71) Key Indexing Terms:
COST OF ILLNESS From the Centre for Health Services Research, Yong Loo Lin School of Medicine, Departments of Pharmacy and Medicine, National University of Singapore; and the Departments of Rheumatology and Immunology and Orthopaedic Surgery, Singapore General Hospital, Republic of Singapore. Supported by an Academic Research Grant from the National University of Singapore, No. R-148-000-059-112. F. Xie, MSc, Research Fellow, Centre for Health Services Research, Yong Loo Lin School of Medicine, National University of Singapore; J. Thumboo, FRCP (Edin), Senior Consultant, Associate Professor, Department of Medicine, National University of Singapore and Department of Rheumatology and Immunology, Singapore General Hospital; N.N. Lo, FRCS (Edin), Senior Consultant; S.J. Yeo, FRCS (Edin), Senior Consultant; K.Y. Yang, FRCS (Glasg), Consultant, Department of Orthopaedic Surgery, Singapore General Hospital; K.Y. Fong, FRCP (Edin), Senior Consultant, Associate Professor, Department of Medicine, National University of Singapore, Department of Rheumatology and Immunology, Singapore General Hospital; S.C. Li, PhD, Associate Professor, Department of Pharmacy, National University of Singapore. Address reprint requests to Dr. S.C. Li, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543. E-mail: phalisc@nus.edu.sg Accepted for publication August 18, 2006. |
