The Impact of Spa Therapy on Ambulatory Health Care Expenses of Osteoarthritic Patients: the Preliminary Results of Ecotherm Study

To describe the cost of ambulatory health care expenses of osteoarthritic patients before and after a spa therapy between 2006 to 2011 among the French state employees. The study is based on patients covered by Mutualité de la Fonction Publique Services (MFPS) Health Insurance Company. All patients older than 49 years, treated with a spa therapy during 2006-2011 period and who have not been treated by spa therapy since at least 2 years were selected and considered as « new spa-goers ». The study focused on « osteoarthritic patients » defined as those treated by a physiotherapist and/or a rheumatologist during the semester before the spa therapy. Data came from MFPS database used to manage the reimbursement of health care expenses. Data were collected on a monthly basis: medical and paramedical fees, drugs expenses, biological and X-Ray fees. All expenses aggregated costs met by National Health Insurance Company (CNAMTS), Complementary Health Insurance Company and patients. Statistical analysis were done using Stata v11 software. The expenses distribution were compared using the Wilcoxon test (p value <0.05). Among 10,540 patients treated by spa therapy, 4,429 osteoarthritic patients (8,072 spa therapy) were selected. The mean level of expenses was 1,714.86 € during the semester before and 1,529.33 € after the spa therapy (p<0.001). This decrease (-185.53 €, -10.8%) concerns physiotherapists fees (- 93.77 €, -41.7%), drugs expenses (-26.70 €, -5.1%), rheumatologists fees (-15.63 €, -42.2%), X-Ray (-17.68 €, -19.7%), GPs fees (-13.33 €, -7.1%) and neurologists fees (-1.66 €, -26.9%). These decreases are greater among the 50-64 years old (-219.58 €, -13.7%) and after the first spa therapy (-206.92 €, -12.8%), but remains significant after next spa therapy. In France, ambulatory health care expenses concerning osteoarthritic patients decreases during the semester following a spa therapy.