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

Abstract

Objectives: To better understand the economic burden of gout patients in Taiwan, a nationwide retrospective study was conducted to compare the healthcare costs and utilization between gout and gout-free patients.

Methods: The Longitudinal Health Insurance Database (LHID) 2010 was used to identify gout cases and matched gout-free controls. Gout cases were defined as having (1) at least three instances of diagnoses of gout on medical claims, or (2) one diagnosis of gout with at least one gout-related pharmacy claim in 2011. A control cohort was matched with cases at a 3:1 ratio by age, gender, residential area, and the Charlson Comorbidity Index. All medical utilization and costs per patient within the 365 days following the index date were compared between cases and controls.

Results: Out of 993,332 beneficiaries, a total of 21,376 matched gout patients met the gout inclusion criteria. Compared to controls, gout patients had more outpatient visits (mean = 31.2 vs 22.6), inpatient visits (mean = 1.7 vs 1.5), and ER visits (mean = 1.9 vs 1.7) (all p < .0001), as well as more outpatient costs (median = USD $634 vs $404), inpatient costs (median = USD $1330 vs $1254), and ER costs (median = USD $87 vs $89) (all p < .05).

Conclusion: Gout patients had higher medical utilization and costs than gout-free patients. In gout patients, all-cause and gout-related utilization were mostly outpatient visits, whereas most of the all-cause and gout-related costs were due to hospitalization. The study findings could be useful for future economic evaluations and healthcare resource allocation.

Keywords:

• Gout
• Pharmacoeconomics
• Cost of illness
• Cost of gout
• Health economics

Transparency

Declaration of funding

This study was funded by the Ministry of Science and Technology, R.O.C (MOST 105-2314-B-038-005) and the Wan Fang Hospital, Taipei, Taiwan (104TMU-WFH-09).

Declaration of financial/other interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial relationships to disclose.

Acknowledgement

We would like to thank Liu Hun-Gyi for his assistance with data analysis.

Previous presentations

This study was presented as a poster at the 7th Asia-Pacific Conference, September 3–6, 2016, Singapore.