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A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model

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. OBJECTIVES: We used a Markov model to calculate lifetime costs of knee OA treatment. We then used the model resu...

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Autores principales: Karmarkar, Taruja D., Maurer, Anne, Parks, Michael L., Mason, Thomas, Bejinez-Eastman, Ana, Harrington, Melvyn, Morgan, Randall, O’Connor, Mary I., Wood, James E., Gaskin, Darrell J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690313/
https://www.ncbi.nlm.nih.gov/pubmed/29036012
http://dx.doi.org/10.1097/MLR.0000000000000816
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author Karmarkar, Taruja D.
Maurer, Anne
Parks, Michael L.
Mason, Thomas
Bejinez-Eastman, Ana
Harrington, Melvyn
Morgan, Randall
O’Connor, Mary I.
Wood, James E.
Gaskin, Darrell J.
author_facet Karmarkar, Taruja D.
Maurer, Anne
Parks, Michael L.
Mason, Thomas
Bejinez-Eastman, Ana
Harrington, Melvyn
Morgan, Randall
O’Connor, Mary I.
Wood, James E.
Gaskin, Darrell J.
author_sort Karmarkar, Taruja D.
collection PubMed
description 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. 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. 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.
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spelling pubmed-56903132017-11-29 A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model Karmarkar, Taruja D. Maurer, Anne Parks, Michael L. Mason, Thomas Bejinez-Eastman, Ana Harrington, Melvyn Morgan, Randall O’Connor, Mary I. Wood, James E. Gaskin, Darrell J. Med Care Award-Winning Manuscripts from APHA 2016 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. 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. 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. Lippincott Williams & Wilkins 2017-12 2017-11-13 /pmc/articles/PMC5690313/ /pubmed/29036012 http://dx.doi.org/10.1097/MLR.0000000000000816 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/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/
spellingShingle Award-Winning Manuscripts from APHA 2016
Karmarkar, Taruja D.
Maurer, Anne
Parks, Michael L.
Mason, Thomas
Bejinez-Eastman, Ana
Harrington, Melvyn
Morgan, Randall
O’Connor, Mary I.
Wood, James E.
Gaskin, Darrell J.
A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title_full A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title_fullStr A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title_full_unstemmed A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title_short A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model
title_sort fresh perspective on a familiar problem: examining disparities in knee osteoarthritis using a markov model
topic Award-Winning Manuscripts from APHA 2016
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690313/
https://www.ncbi.nlm.nih.gov/pubmed/29036012
http://dx.doi.org/10.1097/MLR.0000000000000816
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