A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model.
A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model.
- 2017
Available online from MWHC library: 1996 - present
BACKGROUND: Disparities in the presentation of knee osteoarthritis (OA) and in the utilization of treatment across sex, racial, and ethnic groups in the United States are well documented. CONCLUSIONS: Our results show that disparities in treatment of knee OA are costly. All stakeholders involved in treatment decisions for knee OA patients should consider costs associated with delaying and forgoing treatment, especially for disadvantaged populations. Such decisions may lead to higher costs and worse health outcomes.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/. OBJECTIVES: We used a Markov model to calculate lifetime costs of knee OA treatment. We then used the model results to compute costs of disparities in treatment by race, ethnicity, sex, and socioeconomic status. RESEARCH DESIGN: We used the literature to construct a Markov Model of knee OA and publicly available data to create the model parameters and patient populations of interest. An expert panel of physicians, who treated a large number of patients with knee OA, constructed treatment pathways. Direct costs were based on the literature and indirect costs were derived from the Medical Expenditure Panel Survey. RESULTS: We found that failing to obtain effective treatment increased costs and limited benefits for all groups. Delaying treatment imposed a greater cost across all groups and decreased benefits. Lost income because of lower labor market productivity comprised a substantial proportion of the lifetime costs of knee OA. Population simulations demonstrated that as the diversity of the US population increases, the societal costs of racial and ethnic disparities in treatment utilization for knee OA will increase.
English
0025-7079
*Arthroplasty, Replacement, Knee/ec [Economics]
*Healthcare Disparities/ec [Economics]
*Models, Economic
*Osteoarthritis, Knee/ec [Economics]
Arthroplasty, Replacement, Knee/sn [Statistics & Numerical Data]
Cost-Benefit Analysis
Female
Health Care Costs
Health Services Needs and Demand/ec [Economics]
Health Status Disparities
Humans
Male
Osteoarthritis, Knee/ep [Epidemiology]
United States
MedStar Harbor Hospital
Journal Article
Available online from MWHC library: 1996 - present
BACKGROUND: Disparities in the presentation of knee osteoarthritis (OA) and in the utilization of treatment across sex, racial, and ethnic groups in the United States are well documented. CONCLUSIONS: Our results show that disparities in treatment of knee OA are costly. All stakeholders involved in treatment decisions for knee OA patients should consider costs associated with delaying and forgoing treatment, especially for disadvantaged populations. Such decisions may lead to higher costs and worse health outcomes.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/. OBJECTIVES: We used a Markov model to calculate lifetime costs of knee OA treatment. We then used the model results to compute costs of disparities in treatment by race, ethnicity, sex, and socioeconomic status. RESEARCH DESIGN: We used the literature to construct a Markov Model of knee OA and publicly available data to create the model parameters and patient populations of interest. An expert panel of physicians, who treated a large number of patients with knee OA, constructed treatment pathways. Direct costs were based on the literature and indirect costs were derived from the Medical Expenditure Panel Survey. RESULTS: We found that failing to obtain effective treatment increased costs and limited benefits for all groups. Delaying treatment imposed a greater cost across all groups and decreased benefits. Lost income because of lower labor market productivity comprised a substantial proportion of the lifetime costs of knee OA. Population simulations demonstrated that as the diversity of the US population increases, the societal costs of racial and ethnic disparities in treatment utilization for knee OA will increase.
English
0025-7079
*Arthroplasty, Replacement, Knee/ec [Economics]
*Healthcare Disparities/ec [Economics]
*Models, Economic
*Osteoarthritis, Knee/ec [Economics]
Arthroplasty, Replacement, Knee/sn [Statistics & Numerical Data]
Cost-Benefit Analysis
Female
Health Care Costs
Health Services Needs and Demand/ec [Economics]
Health Status Disparities
Humans
Male
Osteoarthritis, Knee/ep [Epidemiology]
United States
MedStar Harbor Hospital
Journal Article