Comparison of Health-Related Quality of Life, Work Status, and Health Care Utilization and Costs According to Hip and Knee Joint Disease Severity: A National Australian Study.

Autor:	Ackerman, Ilana N., Ademi, Zanfina, Osborne, Richard H., Liew, Danny
Předmět:	ARTHRITIS CONFIDENCE intervals DEMOGRAPHY EMPLOYMENT EPIDEMIOLOGY HIP joint HIP joint diseases KNEE KNEE diseases MEDICAL care use OSTEOARTHRITIS PROBABILITY theory QUALITY of life QUESTIONNAIRES RESEARCH funding STATISTICAL sampling U-statistics DATA analysis SOCIOECONOMIC factors BODY mass index CONTENT mining CROSS-sectional method SEVERITY of illness index
Zdroj:	Physical Therapy; Jul2013, Vol. 93 Issue 7, p889-899, 11p, 1 Diagram, 4 Charts, 1 Graph
Abstrakt:	Background. No population-based studies have investigated how the impact of hip and knee joint disease may vary with increasing severity. Objective. The purpose of this study was to evaluate health-related quality of life(HRQoL), work status, and health service utilization and costs according to severity of hip and knee joint disease.Design. A national cross-sectional survey was conducted. Methods. Five thousand individuals were randomly selected from the Australian electoral roll and invited to complete a questionnaire to screen for doctor-diagnosed hip arthritis, hip osteoarthritis (OA), knee arthritis, and knee OA. Severity was classified by means of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (range0–100): 7asymptomatic, 7–38mild-moderate, and 39severe. Health-related quality of life was evaluated by means of the Assessment of Quality of Life (AQoL) instrument (range0.04 to 1.00; scored worst-best). Self-reported data on work status and health service utilization were collected, with health care costs estimated with the use of government data. Results. Data were available for 1,157 participants, with 237 (20%) reporting hip or knee joint disease. Of these, 16% (n37) were classified as asymptomatic, 51% (n120) as mild-moderate, and 27% (n64) as severe. The severe group reported very low HRQoL (adjusted mean AQoL0.43, 95% confidence interval [95% CI]0.38–0.47) compared with the mild-moderate group (adjusted mean AQoL0.72, 95% CI0.69–0.75) and the asymptomatic group (adjusted mean AQoL0.80, 95% CI0.74–0.86). Compared with the asymptomatic group, the severe group was 3 times less likely to undertake paid work (adjusted odds ratio0.28, 95% CI0.09–0.88) and 4 times less likely to undertake unpaid work (adjusted odds ratio0.24, 95% CI0.10–0.62). Although physical therapy services were used infrequently, primary and specialist care utilization and costs were highest for the severe group. Limitations. Other costs (including physical therapy consultations) were unavailable. Conclusions. A clear pattern of worsening HRQoL, reduced work participation, and higher medical care utilization was seen with increasing severity of joint disease. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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