Arthritis in Canada

An Ongoing Challenge

Adobe Downloadable Document (1,797 KB)

---

Table of Contents

Acknowledgements

Executive Summary 

CHAPTER 1    Introduction 

CHAPTER 2    The Impact of Arthritis on Canadians

• Introduction
• Overview of Arthritis and Rheumatism in Canada
  • How Common is Arthritis?
  • Projections
  • Characteristics of People Living with Arthritis/Rheumatism
• Quality of Life of Individuals with Arthritis
• Visits to Care Providers and Use of Medication
  • Health Services Utilization
  • Access to Health Care
  • Medication Use
• Aboriginal People Living Off-reserve
  • Background
  • Prevalence of Arthritis Among Aboriginals Living Off-reserve and Non-Aboriginal People
  • Quality of Life of Aboriginal People with Arthritis Living Off-reserve and Non-Aboriginal People with Arthritis
• Discussion
• Implications
• Chapter 2 - Methodological Appendix

CHAPTER 3    The Burden of Arthritis in Canada

• Mortality
• Introduction
• Methods
• Results
• Mortality from Arthritis by Age and Sex 
• Mortality by Type of Arthritis
• Trends in Mortality Over Time and Provincial/Territorial Comparisons
• Comparisons with Mortality from Other Causes
• Mortality from Treatment Complications - Gastrointestinal Bleeding 
• Discussion
• Life Expectancy and Health-Adjusted Life Expectancy (HALE)
• Introduction
• The Impact of Eliminating Arthritis on Life Expectancy and HALE
• Discussion
• Economic Burden
• Introduction
• The Cost of Musculoskeletal Diseases
• Costs Attributed to Arthritis 
• Discussion
• Implications
• Chapter 3 - Methodological Appendix 

CHAPTER 4    Ambulatory Care Services 

• Introduction 
• Physician Billing Data
• Physician Visits Among Adults
• Discussion
• Implication
• Chapter 4 - Methodological Appendix

CHAPTER 5    Arthritis-Related Prescription Medications;

• Introduction;
  • Types of Arthritis-related Medications
• Methods;
  • Drug Identification Numbers (DINs)
  • Provincial Drug Plans
• Results;
  • Provincial Time Trends for Arthritis-associated Prescription Drugs
  • Prescriptions and Associated Diagnoses 
• Discussion
• Implications
• Chapter 5 - Methodological Appendix

CHAPTER 6    Hospital Services For Arthritis

• Introduction 
• Hospital Care
• Surgical Interventions
• Data Sources
• Arthritis and Related Diagnoses
• Arthritis and Related Orthopedic Procedures
• Results
• Admissions 
• Orthopedic Procedures  
• Other Orthopedic Procedures
• Discussion
• Implications
• Methodological Appendix - Chapter 6 
• Data Quality Issues
• Technical Methods
• Glossary

CHAPTER 1    Introduction 

Figure 1-1    Components of a Comprehensive Care Approach for the Management of Arthritis and Related Conditions

CHAPTER 2    The Impact of Arthritis on Canadians 

Figure 2-1    Self-reported prevalence of specific chronic conditions, by sex, household population aged 15 years and over, Canada, 2000

Figure 2-2     Self-reported prevalence and number of individuals with arthritis/ rheumatism, by age and sex, household population aged 15 years and over, Canada, 2000

Figure 2-3     Number of individuals with arthritis/rheumatism, by age and sex, household population aged 15 years and over, Canada, 2000

Figure 2-4     Crude (age-sex standardized) prevalence of arthritis /rheumatism, by province/territory, household population aged 15 years and over, Canada, 2000

Figure 2-5     Number of individuals projected to have arthritis/rheumatism, by year and age group, household population aged 15 years and over, Canada, 2001-2026

Figure 2-6     Proportion of individuals with and without arthritis/rheumatism with less than secondary school education, by age, household population aged 15 years and over, Canada, 2000

Figure 2-7     Proportion of individuals with and without arthritis/rheumatism within the lowest/lower-middle income category, by age, household population aged 15 years and over, Canada, 2000

Figure 2-8     Proportion of individuals aged 20 to 64 years who were overweight, by age, household population, Canada, 2000

Figure 2-9     Proportion of individuals reporting any disability days in the previous 14 days, household population aged 15 years and over, Canada, 2000

Figure 2-10     Proportion of people reporting moderate to severe pain, by age, household population aged 15 years and over, Canada, 2000 

Figure 2-11     Proportion of individuals with an HUI indicative of disability, by age, household population aged 15 years and over, Canada, 2000

Figure 2-12     Proportion of individuals reporting activity limitations, by age, household population aged 15 years and over, Canada, 2000

Figure 2-13     Proportion of individuals requiring help with daily activities, by age, household population aged 15 years and over, Canada, 2000

Figure 2-14     Proportion of individuals who rated their health as fair or poor, by age, household population aged 15 years and over, Canada, 2000

Figure 2-15     Proportion of individuals who rated their health as worse than a year earlier, by age, household population aged 15 years and over, Canada, 2000

Figure 2-16     Proportion of people reporting less than 6 hours of sleep per night, by age, household population aged 15 years and over, Canada, 2000

Figure 2-17     Proportion of individuals reporting sleeping problems most of the time, by age, household population aged 15 years and over, Canada, 2000

Figure 2-18     Proportion of individuals reporting life to be extremely stressful, by age, household population aged 15 years and over, Canada, 2000

Figure 2-19     Proportion of individuals with case depression, by age, household population aged 15 years and over, Canada, 2000 

Figure 2-20     Proportion of individuals not in the labour force, by age, household population aged 25 years and over, Canada, 2000

Figure 2-21     Proportion of individuals who reported being physically inactive, by age, household population aged 15 years and over, Canada, 2000

Figure 2-22     Proportion of individuals who consulted a primary care physician at least four times in previous year, by age, household population aged 15 years and over, Canada, 2000

Figure 2-23     Proportion of individuals who consulted a specialist at least once in the previous year, by age, household population aged 15 years and over, Canada, 2000

Figure 2-24     Proportion of individuals with arthritis who consulted a primary care physician or a specialist, by province/territory, household population aged 15 years and over, Canada, 2000 

Figure 2-25     Proportion of individuals who indicated that they required but did not receive health care in the previous year, by age, household population aged 15 years and over, Canada, 2000

Figure 2-26     Proportion of individuals who had taken pain relievers (including arthritis medicine and anti-inflammatories) in the previous month, by age, household population aged 15 years and over, Canada, 1998/99

Figure 2-27     Proportion of individuals who had taken narcotic pain medication in the previous month, by age, household population aged 15 years and over, Canada, 1998/99

Figure 2-28     Proportion of individuals who had taken antidepressants in the previous month, by age, household population aged 15 years and over, Canada, 1998/99

Figure 2-29     Standardized prevalence rates of specific chronic conditions among Aboriginal people living off-reserve and non-Aboriginal people aged 15 years and over, household population, Canada, 2000

Figure 2-30     Self-reported prevalence of arthritis among Aboriginal people living off-reserve and non-Aboriginals, by age and sex, household population aged 15 years and over, Canada, 2000

Figure 2-31     Proportion of individuals with arthritis who reported an HUI score indicative of disability, by age, Aboriginal people living off-reserve and non-Aboriginal people, household population aged 15 years and over, Canada, 2000

Figure 2-32     Proportion of individuals with arthritis reporting activity limitations, by age, Aboriginal people living off-reserve and non-Aboriginal people, household population aged 15 years and over, Canada, 2000

CHAPTER 3    The Burden of Arthritis in Canada 

Figure 3-1     Number of deaths and mortality rates (deaths per 100,000) attributed to arthritis and related conditions, by age and sex, Canada, 1998

Figure 3-2     Standardized mortality rates (deaths per 100,000) for all ages, by type of arthritis, Canada, 1985-1998

Figure 3-3     Mortality rates (deaths per 100,000) for arthritis and related conditions, by year and age group, 1985-1998, Canada

Figure 3-4     Age- and sex-standardized mortality rates (ASMR) (deaths per 100,000) for arthritis and related conditions, by province/territory, Canada, 1985-1998

Figure 3-5     Economic burden of arthritis, by cost component, Canada, 1998

CHAPTER 4    Ambulatory Care Services 

Figure 4-1     Person-visit rates to all physicians for arthritis and related conditions, by age, Canada, 1998/99

Figure 4-2     Person-visit rates to all physicians for osteoarthritis, by age, Canada, 1998/99 

Figure 4-3     Person-visit rates to all physicians for rheumatoid arthritis, by age, Canada, 1998/99

Figure 4-4     Percentage of adults aged 15 years and over with arthritis and related conditions who saw surgical and medical specialists, Canada, 1998/99

Figure 4-5     Percentage of adults aged 15 years and over with osteoarthritis who saw surgical and medical specialists, Canada, 1998/99

Figure 4-6     Percentage of adults aged 15 years and over with rheumatoid arthritis who saw surgical and medical specialists, Canada, 1998/99

Figure 4-7     Percentage of adults aged 15 years and over with osteoarthritis who saw a surgical specialist, by age, Canada, 1998/99

Figure 4-8     Percentage of adults aged 15 years and over with rheumatoid arthritis who saw medical specialists, by age, Canada, 1998/99

Figure 4-9     Average number of visits for arthritis and related conditions, osteoarthritis and rheumatoid arthritis by adults aged 15 years and over, by type of physician, Canada, 1998/99

CHAPTER 5    Arthritis-Related Prescription Medications 

Figure 5-1     Percentage of individuals aged 15 to 64 years with prescriptions for conventional NSAIDs in five provinces, Canada, 1994-2000

Figure 5-2     Percentage of individuals aged 65 years and over with prescriptions for conventional NSAIDs in five provinces, Canada, 1994-2000;

Figure 5-3     Percentage of individuals aged 65 years and over with prescriptions for COX-2 inhibitors in five provinces, Canada, 2000

Figure 5-4     Percentage of individuals aged 15 to 64 years with prescriptions for corticosteroids in five provinces, Canada, 1994-2000

Figure 5-5     Percentage of individuals 65 years and over with prescriptions for corticosteroids in five provinces, Canada, 1994-2000

Figure 5-6     Percentage of individuals aged 15 to 64 years with prescriptions for DMARDs in five provinces, Canada, 1994-2000

Figure 5-7     Percentage of individuals 65 years and over with prescriptions for DMARDs in five provinces, Canada, 1994-2000

CHAPTER 6    Hospital Services for Arthritis 

Figure 6-1     Hospital services for people with arthritis and related conditions

Figure 6-2     Age- and sex-standardized rate of hospital admissions, by diagnosis, Canada, 1994 - 2000

Figure 6-3     Rate of arthritis-related hospital admissions per 100,000 population, by age and sex, Canada, 2000

Figure 6-4     Age- and sex-standardized rate of medical admissions per 100,000 population for people with an arthritis-related condition, by province, Canada, 1994-2000

Figure 6-5     Number of inpatient and outpatient arthritis-related orthopedic procedures in selected provinces, Canada, 1994-2000

Figure 6-6     Number of arthritis-relevant orthopedic procedures in selected provinces, Canada, 2000

Figure 6-7     Number of total hip and knee replacements per 100,000 population, Canada, 1994 - 2000

Figure 6-8     Age-standardized rate of total hip or knee replacement per 100,000 population, by sex, Canada, 1994-2000

Figure 6-9     Number and crude rate of total knee replacements per 100,000 population, by age, Canada, 2000

Figure 6-10     Number and crude rate of total hip replacements per 100,000 population, by age, Canada, 2000

Figure 6-11     Average length of stay for patients with arthritis or a related condition undergoing total hip or knee replacement, by sex, Canada, 2000

Figure 6-12     Average length of stay for patients with arthritis or a related condition undergoing total hip replacement surgery, by sex and province, Canada, 2000

Figure 6-13     Average length of stay for patients with arthritis or a related condition undergoing total knee replacement surgery, by sex and province, Canada, 2000

Figure 6-14     Age-standardized rates of other replacements per 100,000 population for selected provinces, Canada, 1994-2000

Figure 6-15     Rates of other replacements per 100,000 population for selected provinces, by age and sex, Canada, 1994-2000

Figure 6-16     Age- and sex-standardized rates of knee procedures (excluding total knee replacements) for selected provinces per 100,000 population, Canada, 1994-2000

Figure 6-17     Rate of knee arthroscopy per 100,000 population in selected provinces, by age and sex, Canada, 2000

Figure 6-18     Age- and sex-standardized rates of spine and other non-knee procedures per 100,000 population for selected provinces, Canada, 1994-2000

Figure 6-19     Rate of spine and other non-knee procedures per 100,000 population in selected provinces, by age and sex, Canada, 2000

CHAPTER 1    Introduction 

Table 1-1    Major types of arthritis

CHAPTER 2    The Impact of Arthritis on Canadians 

Table 2-1    Projected number of individuals aged 15 years and over with arthritis /rheumatism and prevalence of the condition, by sex, Canada, 2001-2026

Table 2-2    Marital status of individuals with and without arthritis/rheumatism, by sex, household population aged 15 years and over, Canada, 2000

Table 2-3    Proportion of individuals who consulted a specified health care provider at least once, household population aged 15 years and over, Canada, 2000

CHAPTER 3    The Burden of Arthritis in Canada 

Table 3-1     Number (N) of deaths and mortality rate (deaths per 100,000) for all ages, by underlying cause, Canada, 1998 

Table 3-2     Number (N) of deaths and mortality rates (deaths per 100,000) for gastrointestinal (GI) bleeding, by age and sex, Canada, 1998

Table 3-3     Effect of eliminating arthritis on life expectancy at birth, Canada, 1997 (1996-1998)

Table 3-4     Effect of eliminating arthritis on health-adjusted life expectancy (HALE) at birth, Canada, 1997 (1996-1998)

Table 3-5     Economic burden of arthritis, by cost component, Canada, 1998

Table 3A-1     Arthritis and gastrointestinal bleeding mortality codes 

Table 3A-2     Methods for calculating life expectancy and health-adjusted life expectancy (HALE) for people with arthritis

CHAPTER 4    Ambulatory Care Services 

Table 4-1     Visits to all physicians for arthritis and related conditions among adults aged 15 years and over, Canada, 1998/99

Table 4-2     Person-visit rates to all physicians for arthritis and related conditions among adults aged 15 years and over, by province, Canada, 1998/99

Table 4-3     Distribution of type of physician seen by adults aged 15+ years for arthritis and related conditions, Canada, 1998/99

Table 4A-1     Arthritis and related conditions diagnostic codes

CHAPTER 5    Arthritis-Related Prescription Medications 

Table 5-1     Number and percentage of NSAID, corticosteroid, and DMARD prescriptions for individuals with at least one musculoskeletal (MSK)
diagnosis during the previous year, Quebec, 1998

Table 5A-1     Drug categories

Table 5A-2     Details of provincial drug plans as of January 2003 

CHAPTER 6    Hospital Services for Arthritis

Table 6-1     Age-standardized rates of total hip and knee replacement per 100,000 population, by province, Canada, 1994 and 2000

Table 6-2     Variation in the age- and sex-standardized rate of selected arthritis relevant procedures performed, by province, Canada, 2000

Table 6A-1     Arthritis and related diagnoses

Table 6A-2     Arthritis relevant orthopedic surgical procedure CCP codes