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Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs
The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278799/ https://www.ncbi.nlm.nih.gov/pubmed/27031517 http://dx.doi.org/10.1089/pop.2015.0133 |
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author | Brady, Brenna L. Tkacz, Joseph Meyer, Roxanne Bolge, Susan C. Ruetsch, Charles |
author_facet | Brady, Brenna L. Tkacz, Joseph Meyer, Roxanne Bolge, Susan C. Ruetsch, Charles |
author_sort | Brady, Brenna L. |
collection | PubMed |
description | The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of the measures. Medical, pharmacy, and laboratory claims for RA patients (International Classification of Diseases, Ninth Revision, Clinical Modification 714.x) were extracted from the Optum Clinformatics Datamart database for 2011. Individuals were predominately female and in their mid-fifties. Measure achievement ranged from 55.9% to 80.8%. The mean cost of care for members meeting the measure was $18,644; members who did not meet the measures had a mean cost of $14,973. Primary cost drivers were pharmacy and office expenses, accounting for 42.4% and 26.3% of total costs, respectively. Regression analyses revealed statistically significant associations between biologic usage, which was more prevalent in groups attaining measures, and total expenditure across all measures (Ps < 0.001). Pharmacy costs were similar between both groups. Individuals meeting the measures had a higher proportion of costs accounted for by office visits; those not meeting the measures had a higher proportion of costs from inpatient and outpatient visits. These findings suggest that increased quality may lead to lower inpatient and outpatient hospital costs. Yet, the overall cost of RA care is likely to remain high because of intensive pharmacotherapy regimens. |
format | Online Article Text |
id | pubmed-5278799 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Mary Ann Liebert, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-52787992017-02-04 Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs Brady, Brenna L. Tkacz, Joseph Meyer, Roxanne Bolge, Susan C. Ruetsch, Charles Popul Health Manag Original Articles The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of the measures. Medical, pharmacy, and laboratory claims for RA patients (International Classification of Diseases, Ninth Revision, Clinical Modification 714.x) were extracted from the Optum Clinformatics Datamart database for 2011. Individuals were predominately female and in their mid-fifties. Measure achievement ranged from 55.9% to 80.8%. The mean cost of care for members meeting the measure was $18,644; members who did not meet the measures had a mean cost of $14,973. Primary cost drivers were pharmacy and office expenses, accounting for 42.4% and 26.3% of total costs, respectively. Regression analyses revealed statistically significant associations between biologic usage, which was more prevalent in groups attaining measures, and total expenditure across all measures (Ps < 0.001). Pharmacy costs were similar between both groups. Individuals meeting the measures had a higher proportion of costs accounted for by office visits; those not meeting the measures had a higher proportion of costs from inpatient and outpatient visits. These findings suggest that increased quality may lead to lower inpatient and outpatient hospital costs. Yet, the overall cost of RA care is likely to remain high because of intensive pharmacotherapy regimens. Mary Ann Liebert, Inc. 2017-02-01 2017-02-01 /pmc/articles/PMC5278799/ /pubmed/27031517 http://dx.doi.org/10.1089/pop.2015.0133 Text en © Brady et al. 2016; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Articles Brady, Brenna L. Tkacz, Joseph Meyer, Roxanne Bolge, Susan C. Ruetsch, Charles Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title | Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title_full | Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title_fullStr | Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title_full_unstemmed | Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title_short | Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs |
title_sort | assessment of rheumatoid arthritis quality process measures and associated costs |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278799/ https://www.ncbi.nlm.nih.gov/pubmed/27031517 http://dx.doi.org/10.1089/pop.2015.0133 |
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