Background Osteoarthritis (OA) is associated with healthcare resource utilization and loss or worker productivity. The total direct and indirect costs of OA can differ substantially across systems. No data as yet are available on economic impact of OA in Republic of Moldova.
Objectives To estimate the direct and indirect costs of knee osteoarthritis in Republic of Moldova.
Methods A cross-sectional study was performed from January 2012 to January 2013. There were included 256 patients that fulfilled the ACR classification criteria for knee OA (1991). The direct medical costs comprised: medication, hospitalization, medical visits and investigations; the direct non-healthcare costs included informal care and patient out-of-pocket payments. Human capital approach was used to estimate indirect costs by multiplying: 1) days of absence from work because of OA, with average earnings per capita per day for working patients; or 2) productivity loss with the market price of housekeeping for retirees/homemakers. Mean annual per patient costs were calculated from an employer's perspective. Correlations were also calculated between the costs and quality of life (QoL) that was assessed by KOOS- Knee injury and Osteoarthritis Outcome Score (100% high QoL).
Results There were 256 patients integrated in the study including 196 females and 60 males, mean age (SD) 62.4 (9.5) years (range 37 to 85 years). The disease duration (SD) was 8.1 (6.7) years (range 1-51).The KOOS results showed that the QoL constituted 35.7%, qualified as low. The average total cost excluding joint replacement, accounted $685, and the direct costs represented 71.04% (mean $485) per person per year and indirect costs - 29% ($190), respectively. The direct costs represented 18.4% of annual incomes, the insurance cover just 50.7% from direct costs. The three major components of direct costs were hospitalization (48.3%), drug cost (26.4%) and informal care (13%). We established moderate correlation between direct costs and QoL (r=0.4, p<0.05), therefore the indirect costs were strongly correlated with quality of life level (r=0.7, p<0.05).
Conclusions The direct costs of osteoarthritis in the Republic of Moldova population are high being comparable to those reported in European countries and the economic burden is important by relatively high out-of-pocket expenditures. The indirect costs are not a major component of the cost of illness; this is mainly due to the low monetary value of paid work. Both types of costs correlated with the quality of life.
Disclosure of Interest None declared
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