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Avoidable Hospitalizations in Persons With Rheumatoid Arthritis: A Population-Based Study Using Administrative Data.

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Individuals with rheumatoid arthritis (RA) face a higher risk of avoidable hospitalizations. Enhancing ambulatory care access and quality can help prevent these admissions and reduce healthcare system strain.

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Area of Science:

  • Rheumatology
  • Public Health
  • Healthcare Management

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease impacting joints and potentially other organs.
  • Effective management of RA aims to reduce disease activity and prevent long-term complications, including hospitalizations.

Purpose of the Study:

  • To estimate and compare the incidence rates of avoidable hospitalizations in individuals with rheumatoid arthritis (RA) versus the general population.
  • To identify risk factors associated with avoidable hospitalizations among RA patients.

Main Methods:

  • A cohort study identified RA cases using validated diagnostic codes (ICD-9-CM, ICD-10-CA) from 2002-2023.
  • Ambulatory Care Sensitive Conditions (ACSCs) hospitalizations were identified using diagnostic codes from 2007-2023.
  • Incidence Rate Ratios (IRRs) and Cox proportional hazards models were used to analyze risk and predictors of hospitalizations.

Main Results:

  • RA patients (n=83,811) showed a 1.12 times higher risk of hospitalization for heart failure and pulmonary edema compared to controls (n=190,304).
  • Key predictors for ACSC hospitalizations in RA patients included advanced age, prolonged glucocorticoid use, and comorbid conditions, particularly ACSCs (HR 10.1).

Conclusions:

  • Individuals with RA exhibit an elevated risk of potentially avoidable hospitalizations within three and five years post-diagnosis.
  • Improving access to and quality of ambulatory care, including primary and specialty services, is crucial for preventing unnecessary hospitalizations and alleviating acute care system burden.