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骨关节炎相关的医疗保健利用情况和自付费用是怎样的?一项横断面研究。

What is the healthcare utilisation and out-of-pocket expenditure associated with osteoarthritis? A cross-sectional study.

作者信息

Sibbritt David, Sundberg Tobias, Ward Lesley, Broom Alex, Frawley Jane, Bayes Jessica, Adams Jon

机构信息

Faculty of Public Health, University of Technology Sydney Faculty of Health, Sydney, New South Wales, Australia.

Musculoskeletal and Sports Injury Epidemiology Center, Karolinska Institute, Stockholm, Sweden.

出版信息

BMJ Open. 2022 Mar 9;12(3):e055468. doi: 10.1136/bmjopen-2021-055468.

Abstract

OBJECTIVE

To examine the use and out-of-pocket expenses resulting from consultations, products and practices across conventional, self-care, and complementary medicine (CM) treatments for osteoarthritis (OA) among Australian women.

DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey of 800 women from the 45 and Up Study who had reported a clinical diagnosis of OA.

OUTCOME MEASURES

Women's use of conventional, CM and self-prescribed treatments for OA and the associated out-of-pocket cost.

RESULTS

Completed questionnaires were returned by 403 women (50.4%). Their average time since the first diagnosis of OA was 15.4 years, and self-rated severity of OA was 5.1 (out of 10) over the past 12 months. During the previous year, 67.0% of the women consulted a doctor, 39.2% consulted an allied health practitioner and 34.7% consulted a CM practitioner for their OA. Some women (19%) consulted with practitioner(s) from all three practitioner groups, 27% consulted with practitioner(s) from two of the three practitioner groups, while 6% consulted with a CM practitioner only. Women with a greater time since diagnosis had more consultations, as did women who rated their OA as more severe. Women's average combined out-of-pocket expenditure for OA-related healthcare consultations, prescription medications, products, and practices was $673 per annum. Extrapolated to all Australian women with OA, aged 50 years and over, the total out-of-pocket expenditure for this condition is estimated to be $873 million per annum.

CONCLUSIONS

Australian women with OA use a range of conventional and CM consultations, self-care, products and practices to manage their condition, incurring significant out-of-pocket expenses. Given the high individual and societal burden of OA, there is a need for further research into the concurrent use of different healthcare resources with a view to providing safe, cost-effective management of OA across the healthcare system and the wider community.

摘要

目的

研究澳大利亚女性骨关节炎(OA)患者在传统医学、自我护理及补充替代医学(CM)治疗中咨询、使用产品及采取相关措施所产生的费用及自费情况。

设计、地点及参与者:对“45岁及以上研究”中800名报告临床诊断为OA的女性进行横断面调查。

观察指标

女性对OA的传统医学、补充替代医学及自我用药治疗的使用情况以及相关自费费用。

结果

403名女性(50.4%)返回了完整问卷。她们自首次诊断为OA以来的平均时间为15.4年,在过去12个月中OA的自评严重程度为5.1(满分10分)。在前一年,67.0%的女性因OA咨询过医生,39.2%咨询过专职医疗人员,34.7%咨询过补充替代医学从业者。一些女性(19%)咨询过所有三个从业者群体,27%咨询过三个群体中的两个,而6%仅咨询过补充替代医学从业者。诊断后时间越长的女性咨询次数越多,OA自评严重程度越高的女性咨询次数也越多。女性因OA相关医疗咨询、处方药、产品及措施的平均每年自费支出为673澳元。推算至所有50岁及以上患OA的澳大利亚女性,该病每年的总自费支出估计为8.73亿澳元。

结论

患OA的澳大利亚女性使用多种传统医学和补充替代医学咨询、自我护理、产品及措施来管理病情,产生了大量自费费用。鉴于OA对个人和社会造成的负担较重,有必要进一步研究不同医疗资源的同时使用情况,以便在医疗系统和更广泛社区中提供安全、经济有效的OA管理方案。

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