Pediatric Rheumatology Online Journal → June 2003 → Miscellaneous Topics → Abstract 79

THE ECONOMIC IMPACT OF JUVENILE IDIOPATHIC ARTHRITIS

S. Bernatsky,¹ C. Duffy,² A. Clarke,¹ P. Malleson,³ J. Penrod,¹ M. Gibbon,² O. Ortiz-Alvarez,³ P. Dobkin,¹ D. Feldman,⁴ M. DeCivita.¹

¹Clinical Epidemiology, Montreal General Hospital, Montreal, QC, Canada; ²Rheumatology, Montreal Children's Hospital, Montreal, QC, Canada; ³Rheumatology, BC Children's Hospital, Vancouver, BC, Canada; ⁴Medecine Sociale et Preventive, Universite de Montreal, Montreal, QC, Canada

Juvenile Idiopathic Arthritis (JIA) is a common chronic pediatric disease, but little is known about its economic impact.
Objective: To describe health services use, absenteeism & caregiver time loss in JIA, compared to controls.
Methods: Consecutive clinic attendees with a JIA diagnosis were enrolled (N=154);controls without JIA were selected from orthopedic outpatient clinics(N=127).Data on health services, absenteeism, & time loss in the preceding 3 months were obtained by a standardized questionnaire.For the JIA sample, disease activity data were also collected.Multiple regression was used to identify predictors of health service use, absenteeism,& loss of caregiver workforce time in the JIA sample.
Results: More physician use was seen in the JIA group;100%(95% confidence interval 95.1,100) of JIA subjects had [ge> 1 MD visit in the preceding 3 months,compared to 50.4% (95% CI 41.0, 58.3) of controls. Reports of general practitioner & pediatrician visits were similar, but a marked difference was seen in visits to other specialists; 94.7% (95% CI 86.9, 98.5) of JIA patients had visited another specialist in the preceding 3 months, versus 34.1% of controls (95% CI 25.1, 42.0).Lab tests & other diagnostic procedures were reported more often in JIA subjects (64.0%, 95% CI 52.1, 74.8) than in controls(14.6%, 95% CI 8.6, 21.5).Days of work missed by parents due to their child's health and days of school/daycare missed due to medical reasons did not differ between JIA & controls. Disease activity in JIA patients was independently associated with use of lab tests & x-rays (but not physician visits) & with school/daycare absenteeism, (but not caregiver loss of time).Conclusions: The impact of JIA is substantial; cross-sectional data suggest that disease activity may be an important contributor to health resource use & school/daycare absenteeism.Work is in progress to further describe the economic impact of JIA and its predictors.