To test the clinical equivalence and resource consequences of day care with inpatient care for active rheumatoid arthritis.
Randomised controlled clinical trial with integrated cost minimisation economic evaluation.
Rheumatic diseases unit at a teaching hospital betveen 1994 and 1996.
118 consecutive patients with active rheumatoid arthritis roadmised to receive either day care or inpatient care.
Clinical assessments recorded on admission, discharge, and follow up at 12 months comprised : the health assessment questionnaire, Ritchie articular index, erythrocyte sedimentation rate, hospital anxiety and depression scale, and Steinbrocker functional class.
Resource estimates were of the direct and indirect costs relating to treatment for rheumatoid arthritis.
Secondary outcome measures (health utility) were ascertained by time trade off and with the quality of well being scale.
Both groups had improvement in scores on the health assessment questionnaire and Ritchie index and erythrocyte sedimentation rate after hospital treatment (P<0.0001) but clinical outcome did not differ significantly between the groups either at discharge or follow up The mean hospital cost per patient for day care, £798 (95% confidence interval £705 to £888), was lower than for inpatient care, £1253 (£ 1155 to £ 1370), but this difference was offset by higher community, travel, and readmission costs. (...)
Mots-clés Pascal : Polyarthrite rhumatoïde, Hôpital jour, Essai thérapeutique contrôlé, Economie santé, Analyse coût efficacité, Traitement, Hospitalisation, Homme, Chronique, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Rheumatoid arthritis, Day hospital, Controlled therapeutic trial, Health economy, Cost efficiency analysis, Treatment, Hospitalization, Human, Chronic, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0217298
Code Inist : 002B15D. Création : 11/09/1998.