Reduced utilization and cost of primary care clinic visits resulting from self-care education for patients with osteoarthritis of the knee

Steven A. Mazzuca, Kenneth D. Brandt, Barry Katz, Mark P. Hanna, Catherine A. Melfi

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective. To determine the extent to which the cost of an effective self-care intervention for primary care patients with knee osteoarthritis (OA) was offset by savings resulting from reduced utilization of ambulatory medical services. Methods. In an attention-controlled clinical trial, 211 patients with knee OA from the general medicine clinic of a municipal hospital were assigned arbitrarily to conditions of self-care education (group E) or attention control (group AC). Group E (n = 105) received individualized instruction and followup emphasizing nonpharmacologic management of joint pain. Group AC (n = 106) received a standard public education presentation and attention-controlling followup. A comprehensive clinical database provided data concerning utilization and cost of health services during the following year. Results. Only 25 subjects (12%) were lost to followup. The 94 subjects remaining in group E made 528 primary care visits during the year following intervention, compared with 616 visits by the 92 patients remaining in group AC (median visits 5 versus 6, respectively; P < 0.05). Fewer visits translated directly into reduced clinic costs in group E, relative to controls (median costs [1996 dollars] $229 versus $305, respectively; P < 0.05). However, self-care education had no significant effects on utilization and costs of outpatient pharmacy, laboratory, or radiology services over the ensuing year. The cost per patient to deliver the selfcare intervention was estimated to be $58.70. Conclusion. Eighty percent of the cost of delivering effective self-care education to the knee OA patients in this study was offset within 1 year by the reduced frequency and costs of primary care visits. For >50% of patients receiving the intervention, the savings associated with fewer primary care visits exceeded the cost of self-care education.

Original languageEnglish
Pages (from-to)1267-1273
Number of pages7
JournalArthritis and Rheumatism
Volume42
Issue number6
DOIs
StatePublished - 1999

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Knee Osteoarthritis
Patient Education
Ambulatory Care
Self Care
Primary Health Care
Costs and Cost Analysis
Education
Municipal Hospitals
Controlled Clinical Trials
Arthralgia
Health Services
Medicine
Databases

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Reduced utilization and cost of primary care clinic visits resulting from self-care education for patients with osteoarthritis of the knee. / Mazzuca, Steven A.; Brandt, Kenneth D.; Katz, Barry; Hanna, Mark P.; Melfi, Catherine A.

In: Arthritis and Rheumatism, Vol. 42, No. 6, 1999, p. 1267-1273.

Research output: Contribution to journalArticle

Mazzuca, Steven A. ; Brandt, Kenneth D. ; Katz, Barry ; Hanna, Mark P. ; Melfi, Catherine A. / Reduced utilization and cost of primary care clinic visits resulting from self-care education for patients with osteoarthritis of the knee. In: Arthritis and Rheumatism. 1999 ; Vol. 42, No. 6. pp. 1267-1273.
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abstract = "Objective. To determine the extent to which the cost of an effective self-care intervention for primary care patients with knee osteoarthritis (OA) was offset by savings resulting from reduced utilization of ambulatory medical services. Methods. In an attention-controlled clinical trial, 211 patients with knee OA from the general medicine clinic of a municipal hospital were assigned arbitrarily to conditions of self-care education (group E) or attention control (group AC). Group E (n = 105) received individualized instruction and followup emphasizing nonpharmacologic management of joint pain. Group AC (n = 106) received a standard public education presentation and attention-controlling followup. A comprehensive clinical database provided data concerning utilization and cost of health services during the following year. Results. Only 25 subjects (12{\%}) were lost to followup. The 94 subjects remaining in group E made 528 primary care visits during the year following intervention, compared with 616 visits by the 92 patients remaining in group AC (median visits 5 versus 6, respectively; P < 0.05). Fewer visits translated directly into reduced clinic costs in group E, relative to controls (median costs [1996 dollars] $229 versus $305, respectively; P < 0.05). However, self-care education had no significant effects on utilization and costs of outpatient pharmacy, laboratory, or radiology services over the ensuing year. The cost per patient to deliver the selfcare intervention was estimated to be $58.70. Conclusion. Eighty percent of the cost of delivering effective self-care education to the knee OA patients in this study was offset within 1 year by the reduced frequency and costs of primary care visits. For >50{\%} of patients receiving the intervention, the savings associated with fewer primary care visits exceeded the cost of self-care education.",
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