Abstract
BackgroundFirst-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment. However, the socioeconomic profile of the population that utilizes first-line treatment for hip and knee OA is unclear. The aim of this study was to describe the socioeconomic status (SES) of a population referred to a self-management program for OA, in comparison with that of the general Swedish population.MethodsThis is a cross-sectional study including 72,069 patients with hip or knee OA enrolled in the National Quality Register for Better management of patients with Osteoarthritis (BOA) between 2008 and 2016, and registered before participation in a structured OA self-management program. A reference cohort (n = 216,207) was selected from the general Swedish population by one-to-three matching by year of birth, sex and residence. Residential municipality, country of birth, marital status, family type, educational level, employment, occupation, disposable income and sick leave were analyzed.ResultsThe BOA population had higher educational level than the reference group, both regarding patients with hip OA (77.5% vs 70% with ≥10 years of education), and with knee OA (77% vs 72% with ≥10 years of education). Their average disposable income was higher (median [IQR] in Euro (€), for hip €17,442 [10,478] vs €15,998 [10,659], for knee €17,794 [10,574] vs €16,578 [11,221]). Of those who worked, 46% of patients with hip OA and 45% of the reference group had a blue-collar occupation. The corresponding numbers for knee OA were 51 and 44% respectively. Sick leave was higher among those with hip and knee OA (26%) than those in the reference groups (13% vs 12%).ConclusionsThe consistently higher SES in the BOA population compared with the general population indicates that this self-management program for OA may not reach the more socioeconomically disadvantaged groups, who are often those with a higher disease burden.
Highlights
First-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment
Better management of patients with Osteoarthritis (BOA) includes three parts; 1) training of physiotherapist to deliver OA treatment according to guidelines, 2) first-line treatment of patients with OA, as a structured self-management program with theoretical group sessions and individually adapted exercises and 3) evaluation of patients included in the program in the National Quality Register BOA [5]
This study shows that patients in the BOA population who have hip or knee OA, had an overall higher socioeconomic status (SES) than the general population
Summary
First-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment. Evidence-based first-line treatment of OA includes education, exercises and weight control [4, 5]. These treatments have been shown to reduce the impairments and disabilities caused by OA [4,5,6,7] and potentially to delay joint replacement surgery [6, 8, 9]. Regardless of level of care, is in Sweden primarily financed through public taxes, with a maximum payment of approximately €109 for outpatient visits during a twelve month period, aiming to minimize the financed barriers for seeking health care [10]
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