The economic burden of uncontrolled gout: how controlling gout reduces cost

Figures & data

Table 1. Demographics and health characteristics by gout/non-gout and gout control status.

	Gout control						Omnibus Chi-square/one-way ANOVA p-value
	Controlled gout (n = 344)		Uncontrolled gout (n = 2,215)		Non-gout controls (n = 126,360)
	Mean/Column %	SD/Count	Mean/Column %	SD/Count	Mean/Column %	SD/Count
Age of respondent	62.58	12.02	59.79	12.75	47.62	16.66	<.001
Sex
Female	12.8%	44	22.3%	494	53.3%	67,289	<.001
Male	87.2%	300	77.7%	1,721	46.7%	59,071
Race/ethnicity
Non-Hispanic white	82.3%	283	77.9%	1,726	71.3%	90,075	<.001
Non-Hispanic black	3.8%	13	11.2%	248	11.6%	14,687
Hispanic	5.2%	18	4.8%	106	8.8%	11,062
Other ethnicity	8.7%	30	6.1%	135	8.3%	10,536
Annual household income
< $25k	10.5%	36	20.8%	460	19.5%	24,691	<.001
$25k to $50k	22.1%	76	27.4%	608	26.9%	33,944
$50k to $75k	19.2%	66	20.1%	446	19.7%	24,894
$75k or more	41.6%	143	27.1%	601	26.2%	33,138
Decline to Answer	6.7%	23	4.5%	100	7.7%	9,693
BMI category
Underweight	0.3%	1	0.4%	8	2.0%	2,588	<.001
Normal weight	9.9%	34	10.4%	231	32.6%	41,232
Overweight	39.8%	137	30.2%	670	31.7%	40,010
Obese	48.0%	165	57.3%	1,269	31.0%	39,221
Unknown	2.0%	7	1.7%	37	2.6%	3,309
Charlson comorbidity index scoring	0.95	1.28	1.20	1.80	0.42	1.00	<.001

Abbreviations. ANOVA, analysis of variance; BMI, body mass index; SD, standard deviation.

p-values represent the omnibus analyses assessing differences across all three groups.

Table 2. Cost drivers by gout control status.

	Gout control						Omnibus Chi-square p-value
	Controlled gout (n = 344)		Uncontrolled gout (n = 2,215)		Non-gout controls (n = 126,360)
	Column %	Count	Column %	Count	Column %	Count
Participate in the labor force	35.8%a	123	37.7%a	835	53.9%b	68,117	<.001
	Mean	SD	Mean	SD	Mean	SD	Omnibus one-way ANOVA p-value
Work productivity and activity impairment
Absenteeism* (% work missed)	3.18a,b	12.78	5.29a	16.27	3.59b	13.89	.003
Presenteeism* (% impaired while working)	12.88a	20.88	21.57b	25.97	13.43a	22.41	<.001
Overall work impairment* (% overall work impairment)	15.50a	23.78	24.22b	28.81	15.50a	25.31	<.001
Activity impairment (% activity impairment)	27.38a	29.58	38.23b	31.66	22.04c	28.22	<.001
Resource use in the past 12 months
Number of visits to any HCP	11.78a	11.53	11.43a	12.60	7.13b	11.46	<.001
Number of visits to ED	0.31a	0.90	0.80b	2.95	0.42a	2.22	<.001
Number of hospitalizations	0.29a,b	1.14	0.51a	2.51	0.24b	2.01	<.001

*Asked only of those participating in the labor force.

Abbreviations. ANOVA, analysis of variance; ED, emergency department; HCP, healthcare provider; SD, standard deviation.

p-values represent the omnibus analyses assessing differences across all three groups. For pairwise comparisons, refer to subscripts (e.g. a, b, c) attached to means or percentages. Mean values or percentages in the same row that do not share the same subscript (e.g. XXq vs XXb,) are significantly different at p < .05. If they share the same subscript (e.g. XXa vs XXa or XXa,b vs XXa) then they are not significantly different at p < .05.

Table 3. Annual direct and indirect costs by gout control status.

	Gout control						One-way ANOVA p-value
	Controlled gout (n = 344)		Uncontrolled gout (n = 2,215)		Non-gout controls (n = 126,360)
	Mean	SD	Mean	SD	Mean	SD
Total direct costs	$23,574a	$27,655	$27,074a	$48,727	$13,412b	$37,682	<.001
Cost of HCP visits	$18,081a	$17,719	$16,447a	$18,057	$8,809b	$14,695	<.001
Cost of ED visits	$459a	$1,315	$1,227b	$4,565	$636a	$3,371	<.001
Cost of hospitalizations	$5,033a	$17,529	$9,400b	$39,347	$3,967a	$30,335	<.001
Total indirect costs	$5,622a	$9,913	$9,557b	$13,680	$5,174a	$10,049	<.001
Cost of absenteeism	$1,024a	$5,627	$2,120b	$7,843	$1,159a	$5,428	<.001
Cost of presenteeism	$4,606a	$8,259	$7,436b	$10,504	$4,016a	$7,805	<.001
Total costs	$25,584a	$28,394	$30,672b	$49,670	$16,197c	$38,980	<.001

ANOVA, analysis of variance; ED, emergency department; HCP, healthcare provider; SD, standard deviation.

p-values represent the omnibus analyses assessing differences across all three groups. For pairwise comparisons, refer to subscripts (e.g. a, b, c) attached to means or percentages. Mean values or percentages in the same row that do not share the same subscript (e.g. XXq vs XXb,) are significantly different at p < .05. If they share the same subscript (e.g. XXa vs XXa or XXa,b vs XXa) then they are not significantly different at p < .05.

Table 4. Total costs by gout control status.

	Gout control
	Controlled gout (n = 344)					Uncontrolled gout (n = 2,215)			Non-gout controls (n = 126,360) Estimated mean (SE)
	Estimated mean (SE)	Coefficient vs non-gout controls	Coefficient p-value vs non-gout controls	Coefficient vs uncontrolled gout	Coefficient p-value vs uncontrolled gout	Estimated mean (SE)	Coefficient vs non-gout controls	Coefficient p-value vs non-gout controls
Total cost	$19,166 ($1,121)	0.069	.226	–0.124	.042	$21,191 ($503)	0.193	<.001	$15,819 ($57)

Abbreviations. SE, standard error.

Analysis controlled for confounders from a multivariable regression analysis using a zero-inflated negative binomial model. Covariates included: age, sex, ethnicity, income, body mass index category, and Charlson Comorbidity Index.