Objectives To analyze knee and hip osteoarthritis (OA) healthcare resources utilization and associated factors in Spain.
Methods Consecutive patients aged 50 or older with symptomatic and radiological knee and/or hip OA, who were attended in primary care centers in all regions of Spain were included. Information on demographics, health status (Short Form 12 Health Survey), comorbidities (Charlson Index), clinical (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) and radiologic OA severity (Kellgren/Lawrence [K/L] scale), data related to OA health resources utilization: number of medical and nonmedical visits related to OA, diagnostic and imaging tests, and treatments: analgesic, nonsteroidal antiinflammatory drugs (NSAID) in the previous 6 months were collected in 2 separate, structured, and detailed interviews. Descriptive analyses were performed, and the predictors of OA health resources utilization were assessed in multivariate linear regression models.
Results A total of 1,071 subjects were analyzed (74% women with a mean age of 71 years ± 9 years, mostly retired or housewives). Patient’s knee OA mean duration was 7 years ± 8 years, 3 years ± 6 years for hip OA. The mean (standard deviation) of the healthcare resources use was: 13.1 (17.3) for visits related to OA, 8.95 (7.98) visits to primary care physicians, 0.18 (0.70) visits to rheumatologists, 0.71 (0.88) blood analyses, 1.47 (1.47) knee X-rays, 1 (1.09) hip X-rays, 0.11 (0.54) local steroid injections. We found 114 of urgent visits to the hospital, of which 53 required a hospitalization, with a mean length of stay of 0.43 days (3.44), and almost 100% of patients had tried analgesics and NSAIDs. Worse health status was associated with primary care visits, women and comorbidities with OA hospitalizations, women and OA severity with X-rays, WOMAC score with blood analyses, comorbidities and WOMAC score with the use of analgesic, and the WOMAC score with the use of NSAID. There were no predictors of rheumatology visits.
Conclusions The healthcare resources utilization of knee and hip OA is substantial; most of it is based on clinical visits. Disease severity, poor health status and comorbidities were associated with healthcare use. Surprisingly, there were no predictors of rheumatology visits, though were expected. Therefore, in order to improve healthcare visits, clinical pathways and protocols between primary care and rheumatologist might be developed.
Disclosure of Interest None Declared.