Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Ambulatory Resource Utilization for Gouty Arthritis and Gouty Arthritis Attacks.
Li1, Chenghui, Martin1, Bradley C., Cummins1, Dosha F., Andrews2, L.M., Frech-Tamas2, Feride, Yadao2, Anthony
Gouty arthritis (GA) is increasingly prevalent worldwide and is associated with significant economic burden. The objectives of this study are: 1) to describe ambulatory medical care resource utilization and prescribing patterns for patients with GA and GA attacks as well as the associated costs; and 2) to determine the patient characteristics associated with visits for GA and GA attacks.
Data from the 20022008 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey were used to provide national estimates of office-based visits, hospital outpatient department (OPD) visits, and emergency department (ED) visits in the U.S. Visits associated with GA and GA attacks were identified based on physician diagnosis codes, reason for visit codes, and supplemented with medication mentions for antigout and antihyperuricemic agents during the visits. Rates of visits per 1,000 persons per year in the U.S. population stratified by age, gender, race, ethnicity, and geographic region were estimated using U.S. census data. Unit costs for visits and drug prescribing obtained from a commercial administrative claims database were used to estimate U.S. costs expressed in 2009 dollars. Logistic regression was used to examine patient characteristics associated with ambulatory visits for GA or GA attacks. Data were analyzed using STATA 9.2, accounting for complex survey design, and weights were applied to generate national estimates.
An estimated 7 million ambulatory visits annually were associated with GA, with 2 million (28%) of them attributable to GA attacks. Eighty-nine percent of GA-related visits and 80% of visits for GA attacks occurred in physician offices; 5% and 13% occurred in the EDs, with the remainder in OPDs. The rates were 23.81 and 6.68 visits per 1000 persons per year for GA and GA attacks, respectively, and more than doubled from 2002 to 2008. The rates increased with age and were higher in males (33.85 vs. 13.46 visits per 1000 persons per year in females). Among patients who had an ambulatory visit, the likelihood of GA-related visits increased with the diagnosis of renal disease (OR: 5.38; 95% CI: 3.807.63), hypertension (OR: 2.23; 95% CI: 1.792.77), diabetes (OR: 1.46; 95% CI: 1.151.85), heart failure (OR: 1.81; 95% CI: 1.212.69), and non-GA arthritis (OR: 1.54; 95% CI: 1.022.33). Allopurinol (63%), NSAIDS (20%), and colchicine (17%) were the most frequently recorded drugs during GA-related visits. For visits associated with GA attacks, NSAIDS (44%), colchicine (28%), and allopurinol (26%) were most frequently recorded. The total ambulatory care costs associated with GA were estimated at $923 million per year, with 32% of the costs attributed to GA attacks. Drug costs accounted for 61% of the total costs.
The annual ambulatory care costs associated with GA were near $1 billion with 32% of the costs attributed to GA attacks. Drug expenditures accounted for 61% of the total costs during the period 20022008. Annual rates of GA and GA attack-related ambulatory visits more than doubled from 2002 to 2008 and varied across demographic groups and by patient comorbid conditions.
To cite this abstract, please use the following information:
Li, Chenghui, Martin, Bradley C., Cummins, Dosha F., Andrews, L.M., Frech-Tamas, Feride, Yadao, Anthony; Ambulatory Resource Utilization for Gouty Arthritis and Gouty Arthritis Attacks. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :896