To estimate charges attributable to osteoarthritis (OA) in a managed care organization.
Longitudinal study based on insurance claims incurred and filed between 1991 and 1993 in a national managed care organization. Patients with claims for OA were randomly sampled to yield 20,000 study subjects. Charges per person-year were determined for these patients and compared to those of comparison subjects matched for age, sex, and insurance plan without claims for OA.
Total charges per patient-year adjusted to 1993 dollars for patients with OA <65 and > or =65 years of age were $5,294 and $5,704, respectively, while charges for controls were $2,467 and $3,741, respectively. Thus, charges due to OA were $2,827 and $1,963, accounting for 5% of total plan charges.
Patients with symptomatic OA incur charges for medical care at about twice the rate of plan enrollees without claims for OA and account for a substantial proportion of total charges in a managed care plan.