Health care utilization in patients with gout
Jasvinder A Singh1, A Sarkin, M Shieh
1Birmingham VA Medical Center and University of Alabama 35294, USA. Jasvinder.md@gmail.com
Insights
Gout severity and comorbidities significantly impact healthcare use. Higher gout severity correlates with increased utilization across all services, while comorbidities drive primary care visits for gout patients.
Area of Science:
- Rheumatology
- Health Services Research
- Epidemiology
Background:
- Gout is a common inflammatory arthritis characterized by hyperuricemia and urate crystal deposition.
- Understanding healthcare utilization patterns in gout patients is crucial for resource allocation and patient management.
Purpose of the Study:
- To investigate health care utilization patterns among patients diagnosed with gout.
- To identify factors associated with varying levels of healthcare resource use in gout management.
Main Methods:
- A study involving 296 gout patients from primary care and rheumatology clinics across three U.S. metropolitan areas.
- Data collected on gout-related healthcare utilization (primary care, rheumatology, urgent care, emergency room, hospitalization) over the past year.
- Regression and correlation analyses were used to assess associations between comorbidities, gout severity, and healthcare utilization.
Main Results:
- Higher overall gout severity strongly correlated with increased utilization of all healthcare resources.
- Non-emergency care (primary care, rheumatology) was the most significant predictor of emergency/urgent care utilization for gout.
- Patients with more comorbidities exhibited greater utilization of primary care services for gout management.
Conclusions:
- Overall gout severity is a key determinant of healthcare utilization across various service types.
- Comorbidities are identified as a risk factor for increased primary care utilization in gout patients.
- Findings can inform targeted interventions for high-utilizing gout patients.
Objective:
To study health care utilization patterns in patients with gout.
Methods:
In a gout population from primary care and rheumatology clinics in 3 U.S. metropolitan cities, we collected data on gout-related utilization (primary care, rheumatology, urgent care, emergency room, and other) in the past year. We evaluated the association of comorbidities, age, gender, gout characteristics (time since last gout attack and tophi), and gout severity ratings (mean of serum uric acid, patient-rated, and physician-rated gout severity) and with emergency/urgent care and primary care utilization using regression and correlation analyses.
Results:
Of the 296 patients who reported visiting at least 1 type of health practitioner for gout in the past year, the percentage of patients utilizing the service at least once and annual utilization rates among utilizers were as follows: primary care physician, 60%, 3.0 ± 3.4; nurse practitioner/physician assistant, 26%, 2.7 ± 2.5; rheumatologist, 51%, 3.7 ± 5.7; urgent care, 23%, 2.1 ± 2.2; emergency room, 20%, 2.0 ± 1.7; and hospitalization, 7%, 2.1 ± 1.4. Higher overall gout severity was associated with greater use of each resource type and with overall gout-related utilization. Nonemergency/nonurgent care utilization (primary care physician, nurse practitioner, physician's assistant, and rheumatologist for gout) was the strongest predictor of gout-related emergency/urgent care utilization. Patients with more comorbidities had greater gout-related primary care utilization.
Conclusions:
Overall gout severity was associated with all types of gout-related utilization. This may help to screen high utilizers for targeted behavioral and therapeutic interventions. Having a higher number of comorbid conditions was a risk factor for higher gout-related primary care utilization.
Related Concept Videos
01:28Urinary Tract Calculi V: Nursing Management
01:30Urinary Tract Calculi III: Medical Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:21Nursing Assessment of the Genitourinary System I: Health History
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care