Biomedical subjects

Wilfried Mau

Publications and source records attributed to Wilfried Mau.

5 recordsLinked to original sources

PubMed2005

Indirect cost assessment in patients with rheumatoid arthritis (RA): comparison of data from the health economic patient questionnaire HEQ-RA and insurance claims data.

OBJECTIVE: To render information on the accuracy of patient-reported indirect cost data compared with payer-derived data of the real indirect costs on a patient-by-patient basis concerning disease-related productivity losses in rheumatoid arthritis (RA). METHODS: The assessment of indirect cost data was part of a clinical, multicenter, randomized RA trial. A total of 234 patients of working age with a diagnosis of RA (according to 1987 American College of Rheumatology criteria) were recruited. Demographics of the cohort were mean age 53 years, mean disease duration 8 years, 76% were women, and all had membership in the regional statutory health insurance plan. Every 3 months corresponding indirect cost data were derived for the cohort from a health economic questionnaire for cost assessment in patients with RA and the payer's database over a period of 18 months. Comparative statistical analyses were performed between patient-reported and insurance claims data. RESULTS: The mean annual productivity losses due to sick leave amounted to 14 and 17 days per patient (questionnaire versus payer data), and productivity losses due to work disability amounted to 3 days (both); monetary valuation renders overall costs of 1,240 and 1,590, respectively. The difference of 17% in overall productivity losses is not significant. Comparison of productivity losses reveals a strong correlation of r = 0.83 in those due to sick leave and of kappa = 0.84 in those due to work disability between questionnaire and payer data. CONCLUSION: The comparison of questionnaire and payer data shows that RA patients report their productivity losses adequately. Indirect cost assessment should therefore be included in further RA trials and observational studies.

Adolescent↗

PubMed2005

Prediction of costs-of-illness in patients with low back pain undergoing orthopedic outpatient rehabilitation.

The objectives of this study were (1) to assess societal costs-of-illness and their changes in the year prior to and after outpatient rehabilitation (OPR) in initially gainfully employed persons with low back pain and (2) to identify predictors (cost drivers) for high overall costs in the year after the intervention. The health economical analysis is part of a prospective clinical trial investigating patients participating in orthopedic OPR. In all gainfully employed patients (n=244) resource consumption and productivity losses were assessed prior to OPR and 12 months afterwards. Overall annual medical costs per person were estimated. Parameters associated with high overall costs in the 12 months after OPR were predicted by multivariate logistic regression analysis. All sociodemographic, motivational, clinical, psychological, therapeutic and vocational variables were included as possible predictors. Costs due to sick leave periods represent the major component (83%/58%) of overall costs in both periods. The comparison of costs 12 months before and after OPR reveals a significant reduction from 8050 to 3200 per person, primarily caused by decreasing sick leave costs and the reduction of costs related to inpatient treatment. The prediction analysis reveals that patients with limited functional abilities, with problems due to strenuous labour, with low expectations in terms of possible improvement after OPR, with a high pain score or with limited satisfaction with working colleagues have a significantly higher risk for costs exceeding 2200 after OPR. The identified cost drivers can be used to develop multimodal therapeutic measures, which should be employed during the OPR intervention in order to prevent future costs.

Adult↗

PubMed2005

Employment across chronic inflammatory rheumatic diseases and comparison with the general population.

OBJECTIVE: To compare labor force participation across chronic inflammatory rheumatic diseases in order to assess the influence of the disease, disease duration, sex, education, and labor market conditions on employment. METHODS: Data from the German rheumatological database on outpatients of working age (20-59 yrs) between 1993 and 2001 were analyzed. The patients had rheumatoid arthritis (RA; n = 26,071), ankylosing spondylitis (AS; n = 5564), psoriatic arthritis (PsA; n = 6041), systemic lupus erythematosus (SLE; n = 4603), systemic sclerosis (SSc; n = 802), or Wegener's granulomatosis (WG; n = 385). Using population data, standardized employment ratios (SER) and part-time employment ratios of observed versus expected cases with 95% CI were calculated by means of indirect standardization for age and year of documentation. RESULTS: Across all diseases the overall employment rates were significantly lower than in the general population. Significant differences in SER were found between the diseases. The lowest SER of 0.76 to 0.81 (1.0 = population) were found in patients with RA, SLE, SSc, and WG. Higher SER were seen in AS (0.94) and PsA (0.92). In patients with a disease duration > 10 years the relative risk of being employed compared to RA, was 1.42 for AS, 1.26 for PsA, and 1.15, 1.03, 0.62 for PsA, SLE, SSc and WG, respectively. Comparing areas with low and high unemployment rates, a highly significant influence of labor market conditions on the SER was observed. The SER were significantly lower in patients with < 10 years of school education. CONCLUSION: Differences between employment rates in the population and the rates for the diseases under study are smaller than assumed by most clinical studies, especially in AS and PsA. However, these differences increase with longer disease duration. Specific measures to prevent patients from losing their job are needed, especially in areas with overall high unemployment.

Absenteeism↗

PubMed2003

Changes in quality of life according to the SF36 Health Survey of persons with back pain six months after orthopedic in- and outpatient rehabilitation.

The objective of the current study was to compare changes of various aspects of quality of life according to the SF36 Health Survey after either inpatient rehabilitation (IPR) or outpatient rehabilitation (OPR) in patients with low back pain. To do this, a follow-up study (6 months) with a case-control design (n=150 matched pairs) of prospectively recruited patients suffering from low back pain and participating either in IPR or in OPR was carried out. To compare the effectiveness of IPR and OPR in terms of quality of life, the effect sizes (ES) of the changes in SF36 subscales 6 months after the rehabilitation programmes had ended were determined in those patients who had displayed abnormal values in the SF36 subscales before the intervention. The most important improvements in both IPR and OPR are found for "bodily pain" and "physical role". The improvement in "physical role" is higher after OPR (OPR 1.7; IPR 1.2), whereas the change in the subscale "mental health index" is lower after OPR (OPR 0.5; IPR 1.0). After adjusting for differing baseline values, improvements of psychosocial aspects such as "vitality" and "social function" tend to be more pronounced after IPR ("vitality": IPR 1.3; OPR 0.8; "social function": IPR 1.0; OPR 0.6). The outcome of IPR and OPR is similar in terms of several aspects of quality of life. However, the differences in psychosocial aspects result in the assumption that patients with impaired mental health, vitality or social abilities might receive a greater benefit from IPR whereas those with an impaired physical role might profit more from OPR. This needs to be studied in more detail in randomized controlled trials.

Adult↗

PubMed2003

[Rheumatology].

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Germany↗