Osteoarthritis is the most common form of arthritis in Australia with the Australian Bureau of Statistics estimating 1.8 million people, or 8 per cent of the population, are living with the disease.
A degenerative condition that mostly affects the hands, spine and joints, osteoarthritis (OA) is a highly debilitating long-term condition, particularly among older Australians.
As well as being older, being female increases the likelihood of developing osteoarthritis with nearly twice as many women as men suffering the pain and disability of the disease.
UniSA School of Pharmacy and Medical Sciences Senior Research Fellow, Dr Gillian Caughey, part of a team of researchers from around Australia, examined the impact of incident osteoarthritis on health service use by ‘baby boomer’ Australian women to provide insight into the changes in health care use after a diagnosis of OA.
“The prevalence of OA is increasing as our population ages and the World Health Organisation estimates that 20 per cent of the global population will be aged over 60 years by 2050 which will mean 130 million people will have OA worldwide with 40 million of those severely disabled by OA,” Dr Caughey says.
“There is no cure for OA so treatment focuses on pain management and maintenance of joint mobility, function and wellbeing so in an environment of constrained government spending, it is important for policymakers to understand the factors that enable people with OA to remain active and independent in the community with optimal functional capacity.
“Government reports on healthcare use by people with arthritis, based on national and regional (aggregated) data, cannot track change in healthcare use related to OA or the increasing severity of the disease so individual level data is needed to understand the course of healthcare access and demand in relation to OA.
“What we found was that after onset of OA, women reduce their doctor visits while increasing allied health services, relative to the rates observed in those without a diagnosis.”
The management of osteoarthritis in Australia takes place in a variety of health care settings, to cater for different aspects of care including general practice, allied health professionals, and specialist surgeries and hospitals.
The government–funded Australian health care system provides services across the spectrum of care but the costs of allied health professionals such as physiotherapists and chiropractors are usually met by patients themselves with the support of private health insurance.
“The main symptoms of osteoarthritis are pain, stiffness and limited joint movement. At first pain is felt during and after activity, but as the condition worsens pain may be felt during minor movements or even at rest,” Dr Caughey says.
“As osteoarthritis progresses the capacity to participate fully in the workforce declines so if better and more efficient health care services are in place to support people with OA the burden of this disease can be reduced.
“The increase we found in allied health services items is of particular interest, as these items are limited by both eligibility and in number and rebate is available for an absolute maximum of five services each calendar year.
“Thus, we could hypothesise that the decrease in doctor visits and increase in allied health service visits may have been greater without these restrictions.
“These findings suggest the importance of making a positive diagnosis of OA to optimise effective use of health services, such as allied health, in accord with recommended Australian treatment guidelines and will have particular significance to GP practice.
“We expect that this information on the way in which informed OA patients are likely to navigate through the health system may assist policymakers in planning for future costs related to this disease; costs that are expected to increase substantially as the population ages.”
Incident osteoarthritis associated with increased allied health services use in ‘baby boomer’ Australian women authored by Lynne Parkinson, Rachael Moorin, Geeske Peeters, Julie Byles, Fiona Blyth, Gillian Caughey, Michelle Cunich, Parker Magin, Lyn March and Dimity Pond is being published in the Australian and New Zealand Journal of Public Health on May 16 2016.
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