What Arthritis Costs Indiana
Arthritis and Indiana:
Our State's Burden
In 2005, Indiana residents had 21,063 hospitalizations with a primary discharge diagnosis of arthritis. Hospital charges were more than $610 million. The majority of the hospitalizations (78 percent) were due to osteoarthritis.15 The average charge for arthritis procedures has increased almost 13 percent between 2004 ($25,651) and 2005 ($29,001). As the state’s population continues to age, the cost of arthritis will increase. Charges for treatment of osteoarthritis (knee and hip replacement) were five times more than all other diagnoses combined.
Table 1
Total Charges for Indiana Arthritis Inpatients by Type of Arthritis, 2005
| ARTHRITIS DIAGNOSIS | Number of Discharges |
Hospital Charges |
Average Charge |
|---|---|---|---|
| Osteoarthritis Spondylosis/spondylitis and allied disorders Soft tissue disorders (excluding back) Joint pain, effusion, & other unspecified joint disorder Rheumatoid arthritis Diffuse connective tissue disease Gout & other crystal arthropathies Myalgia/myositis unspecified Carpal tunnel syndrome16 |
16,444 1,350 1,374 769 395 267 321 120 23 |
$510,331,306 $44,483,599 $23,851,115 $11,752,764 $8,265,212 $7,670,617 $3,089,480 $1,202,425 $221,055 |
$31,034.50 $32,950.81 $17,358.89 $15,283.18 $20,924.59 $28,728.90 $9,624.55 $10,020.21 $9,611.09 |
| All arthritis discharges | 21,063 | $610,867,573 | $29,001.93 |
Since most people with arthritis do not require hospital care, hospitalization costs reflect only a part of the entire burden. Other costs include physician visits, emergency room visits, physical therapy, occupational therapy, nursing home care, mental health counseling, x-rays, laboratory tests, and prescription and over-the-counter medications. Assistive devices like canes, crutches, and walkers, and “alternative” therapies such as chiropractic, acupuncture, and glucosamine and chondroitin sulfate supplements also contribute to the cost of arthritis care.
Economists estimate that 52 percent of the nation’s costs from musculoskeletal conditions are due to indirect costs resulting from wage losses of people with arthritis and their caregivers.16 Intangible costs include pain, psychological suffering, and the stress placed on families.
Figure 24
Average Hospital Inpatient Charge per Procedure 2003-2005
(Indiana Hospital Discharge Data)
 |
The average hospital charges for some types of arthritis procedures have increased while others have remained constant. Cost increases for osteoarthritis and spondylosis/spondylitis have increased most notably between 2003 and 2005, over $6,400 for osteoarthritis and almost $10,000 for spondylosis/spondylitis.
Table 2 indicates the most common diagnoses and procedures performed by hospitals in 2005. Osteoarthritis accounted for 93.9 percent of the most common arthritis hospital inpatient procedures.
Table 2
Matrix of Most Common Arthritis Diagnosis and Procedures
(Indiana Hospital Discharge Data)
|
|
Spondylosis/ |
Rheumatoid |
Osteoarthritis |
Joint pain |
Soft tissue |
Total |
|
Diagnosis |
spondylitis |
arthritis |
|
effusion, |
disorders |
|
|
|
and allied |
|
|
other |
excluding back |
|
|
|
disorders |
|
|
unspecified |
|
|
|
Procedure |
|
|
|
joint |
|
|
|
|
|
|
|
disorders |
|
|
|
Spinal fusion |
620 |
1 |
2 |
0 |
7 |
630 |
|
Total hip replacement |
3 |
42 |
4,075 |
53 |
0 |
4,173 |
|
Total knee replacement |
4 |
108 |
11,080 |
94 |
0 |
11,286 |
|
Arthroplasty and repair of shoulder & elbow |
0 |
22 |
485 |
28 |
32 |
567 |
|
Total |
627 |
173 |
15,642 |
175 |
39 |
16,656 |
_________________________________
15 2005 Hospital Discharge Data. Source: Indiana State Department of Health, Epidemiology Resource Center. ICD-9 codes used to compute arthritis data were those defined by the National Arthritis Data Workgroup (NADW), which is composed of researchers from CDC, AF, and the American College of Rheumatology (ACR). For a list of the ICD-9 codes, see CDC, Arthritis prevalence and activity limitations, MMWR, June 24, 1994, 43(24):433-438.
16 This does not include outpatient charges. In 2005, there were 7,383 procedures performed for carpal tunnel with a total charge of $21,243,800.
17 Yelin E; Callahan LF. The economic cost and social and psychological impact of musculoskeletal conditions. Arthritis Rheum. 1995 Oct; 38(10):1351-62.
