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. 2017 Mar;36(3):499-506.
doi: 10.1007/s10067-016-3470-z. Epub 2016 Nov 10.

Non-medical costs during the first year after diagnosis in two cohorts of patients with early rheumatoid arthritis, enrolled 10 years apart

Magnus Husberg  1 , Thomas Davidson  1 , Eva Hallert  2
Affiliations

Non-medical costs during the first year after diagnosis in two cohorts of patients with early rheumatoid arthritis, enrolled 10 years apart

Magnus Husberg et al. Clin Rheumatol. 2017 Mar.

Abstract

The aim of the present study was to calculate non-medical costs during year 1 after diagnosis in two cohorts of patients with early rheumatoid arthritis enrolled 1996-1998 and 2006-2009. Clinical data were collected regularly in both cohorts. Besides information about healthcare utilization and days lost from work, patients reported non-medical costs for aids/devices, transportation, formal and informal care. Formal care was valued as full labour cost for official home help (€42.80/h) and informal care from relatives and friends as opportunity cost of leisure time, corresponding to 35% of labour cost (€15/h). In both cohorts, only 2% used formal care, while more than 50% used informal care. Prescription of aids/devices was more frequent in cohort 2 and more women than men needed aids/devices. Help with transportation was also more common in cohort 2. Women in both cohorts needed more informal care than men, especially with personal care and household issues. Adjusting for covariates in regression models, female sex remained associated with higher costs in both cohorts. Non-medical costs in cohort 2 were €1892, €1575 constituting informal care, corresponding to 83% of non-medical costs. Total non-medical costs constituted 25% of total direct costs and 11% of total direct and indirect costs. Informal care accounted for the largest part of non-medical costs and women had higher costs than men. Despite established social welfare system, it is obvious that family and friends, to a large extent, are involved in informal care of patients with early RA, and this may underestimate the total burden of the disease.

Keywords: Cohort study; Disease activity; Early rheumatoid arthritis; Gender; Health services research; Non-medical costs.

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Conflict of interest statement

Disclosures

None.

All patients gave written informed consent to participation. The study protocol was approved by the local ethics committee in Linkoping (Dnr M 168–05)

Funding

This work was supported by the County Council in Östergötland, Sweden, and the Medical Research County Council of South-East Sweden (FORSS).

Figures

Fig. 1
Fig. 1
Direct costs, indirect costs and non-medical costs and proportions of costs. Non-medical costs are divided into costs for informal care and costs for other non-medical issues comprising formal care, aid/devices and transportation
See this image and copyright information in PMC

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