© 1994 British Society for Rheumatology
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A PILOT STUDY OF THE ECONOMIC COST AND CLINICAl OUTCOME OF DAY PATIENT VS INPATIENT MANAGEMENT OF ACTIVE RHEUMATOID ARTHRITIS
*Economic and Health Outcomes Research Group, Rheumatic Diseases Unit, Western General Hospital Edinburgh
Department of Public Health Sciences, Medical School, University of Edinburgh
Correspondence to:
Correspondence to: N. P. Hurst, EcHO Research Group, Rheumatic Diseases Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU.
The aims of this pilot study, which compares day patient with inpatient care for management of active RA were (i) to test feasibility of a trial protocol design including the method of randomization and the practicality of data collection, and to obtain preliminary information on economic cost and clinical outcome of these two methods of management.Twenty consecutive patients requiring admission for management of active RA were randomized to receive either day patient or inpatient care. All hospital, transport, community and indirect costs incurred over a 6-month period from recruitment were collected for each patient. Disease activity and clinical outcome were assessed using the Ritchie articular index, ESR, Health Assessment Questionnaire, Functional Independence Measure and Hospital Anxiety and Depression Scale. The trial protocol was found to be feasible and no patient allocated to the day patient group requested or required to transferred to inpatient care. Day care was significantly cheaper than inpatient care despite higher transport costs; the total cost of treating 10 day patients was UK£ 10 272 compared with£14 528 for 10 inpatients. Clinical outcome was comparable in both groups for all parameters studied and there was no obvious detrimental effect on patients receiving care. This pilot study demonstrates that day care is feasible and acceptable to patients with active RA. The preliminary data suggest that day care is substantially cheaper than inpatient care and does not apparently compromise clinical outcome.
KEY WORDS: Rheumatoid arthritis, Day care, Outcome, Therapy, Health economics
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