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Impact of chronic hand dermatitis on quality of life, work productivity, activity impairment, and medical costs.

Fowler JF, Ghosh A, Sung J, Emani S, Chang J, Den E, Thorn D, Person J, Duh MS

University of Louisville, Louisville, Kentucky, USA.

BACKGROUND: The impact of chronic hand dermatitis (ChHD) on patient-reported outcomes and economic costs has not been assessed in a US population. OBJECTIVE: We sought to evaluate the quality of life, work productivity, activity impairment, and health care costs of patients with ChHD versus those without ChHD. METHODS: A 13-item self-assessment questionnaire to identify ChHD was developed and validated. Skindex-29 and Work Productivity and Activity Impairment questionnaires were used to assess quality of life and work productivity for ChHD. The survey was mailed to a random sample of 1380 members of a Massachusetts managed care organization (N = 507, response rate = 36.74%). Univariate and multivariate analyses were conducted to determine the incremental effect of ChHD on quality of life, work productivity, and activity impairment. Health insurance claims were used to assess medical costs. RESULTS: Quality of life, along with work productivity and activity impairment, were significantly worse for patients with CHD than for those without ChHD; however, there was no significant difference in work time missed. After adjusting for significant covariates, a 25% cost increase in total medical costs was found attributable to ChHD, which translates to an incremental cost of $70 per patient per month. LIMITATIONS: Survey response rate is not high; the survey respondents may not be completely representative of the nonrespondents. The cost burden of ChHD is underestimated because of the omission of over-the-counter drug and indirect costs. The multivariate models had a low goodness of fit indicated by the low R2 statistics. CONCLUSIONS: ChHD has a significant detrimental effect on quality of life, work productivity, activity impairment, and heath care costs. More awareness and treatment of this condition are needed to improve patient outcomes and decrease health care cost.

Published 20 February 2006 in J Am Acad Dermatol, 54(3): 448-57.
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