Evaluation of healthcare costs and utilization for patients with gout: a population-based matched cohort study

Lee, Yi-Yun; Tang, Chao‐Hsiun; Chen, Jinhua; Kuo, Li-Na; Ko, Yu

doi:10.1080/03007995.2017.1417826

Cited by 7 publications

(7 citation statements)

References 18 publications

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“…One might postulate that the widespread nature of gout might not have motivated clinicians to report comorbid gout among patients with AKN. However, since gout imposes a substantial burden and healthcare costs, 14 it is of great importance to delineate the risk of gout in AKN. This knowledge is of great clinical implication as it might increase the awareness of clinicians about the need for primary prevention of gout in AKN by treating modifiable risk factors.…”

Section: Discussionmentioning

confidence: 99%

The burden of gout in acne keloidalis nuchae—Insights from a population‐based study

Shavit

Cohen

Zoller

et al. 2022

J of Cosmetic Dermatology

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Acne keloidalis nuchae (AKN) represent a chronic deep-seated scarring folliculitis that predominantly involves the nape, but other anatomical regions of the scalp might be implicated as well. It is more commonly observed in dark-skinned male patients, and women are less frequently affected. 1 The disease is considerably less frequent in other ethnic populations. 2,3 AKN is characterized clinically by large, indurated papules, pustules, and nodules coalescing into keloid-like plaques, hence the name. Histologically, it is represented as a deep inflammatory lesion in the mid-lower dermis with naked hair shafts. Treatment is challenging and relies on topical and intralesional corticosteroids in combination with systemic antibiotics for the inflammatory lesions and on surgical therapy or laser for the keloidal component of the disease. 4,5

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Section: Discussionmentioning

confidence: 99%

The burden of gout in acne keloidalis nuchae—Insights from a population‐based study

Shavit

Cohen

Zoller

et al. 2022

J of Cosmetic Dermatology

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“…Gout patients are known to have more frequent outpatient, inpatient and emergency room visits as well as increased costs of care for these visits. 21 Moreover, patients that have frequent gout flares have both; increased goutrelated health care utilization as well as all-cause health care utilization. 22 These data are salient in the current bundled care payment environment, as it implies that controlling gout patients' frequency of flares can be an efficacious way of both decreasing all-cause health care utilization as well as cost in the perioperative setting after TKA.…”

Section: Discussionmentioning

confidence: 99%

Gout As a Predictor of Total Knee Arthroplasty Outcomes and Costs

et al. 2020

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Gout is the most common inflammatory arthritis and affects approximately 4% of the U.S. population. As the prevalence of gout and the number of total knee arthroplasties (TKAs) performed continue to increase, the literature on TKA in patients with gout remains scant. The purpose of this study was to evaluate the outcomes of patients with gout following TKA at a population level, that is, how patient with gout fair after TKA. We hypothesized that patients with gout have higher rates of complications and higher costs compared with controls. A case–control study was designed to evaluate two cohorts of Medicare patients who underwent TKA whose only distinguishing feature was the presence or absence of gout. Matching was performed to decrease confounding at a 1:1 ratio based on age, gender, and Charlson comorbidity index (CCI), (10-year survival predictor). The Medicare standard analytical files were queried through International Classification of Disease and current procedural terminology codes. A total of 15,238 patients were evaluated with 7,619 in each cohort. There were no age, gender, or CCI differences and 57.4% were females. Day of surgery and 90-day post-surgery costs were both significantly greater in those with gout (p < 0.001 for both). Multivariate analysis revealed that gout patients had increased odds of infection (odds ratio [OR] 1.229, p = 0.019), cardiac arrest (OR 1.354, p = 0.002), pneumonia (OR 1.161, p < 0.001), hematoma (OR 1.204, p = 0.002), and development of capsulitis (OR 1.208, p = 0.012). Nonetheless these patients had a decreased risk of pulmonary emboli (OR 0.835, p = 0.016). Our results support our hypothesis that patients with gout have higher rates of postoperative complications and increased day of surgery and 90-day costs of care after TKA. Given the high prevalence of gout in the United States, additional study on the utility of preoperative gout optimization for TKA patients is warranted. The level of evidence of this study is III, and it is a retrospective case–control study.

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“…Inadequate patient and provider education further leads PCP and their gout patients away from optimal treatment 9 . These factors contribute to a large disease burden for patients, who, in the face of poor gout control, have more outpatient visits, emergency room visits, and inpatient stays than matched patients without gout, with subsequent increased healthcare utilization and costs 10 . Education and persistence about urate lowering works: In one study, Doherty, et al reported that training research nurses to deliver guideline-based gout care resulted in improved adherence to ULT, better achievement of target urate, and better patient quality of life, as well as corresponding decreases in tophi and cost of care, compared to usual care by general practitioners over a 2-year period 11 .…”

Section: Editorialmentioning

confidence: 99%