Patterns of health care utilization of gout patients in Hawai‘i-high rates of emergency department utilization as compared to rheumatoid arthritis

Recent and comprehensive research of gout in the Pacific region and Hawai‘i is significantly lacking. This study was conducted to improve the understanding of the healthcare utilization of gout patients within a single health care system in Hawai‘i. The objective was to examine gout inpatient, outpa...

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Bibliographic Details
Published in:PloS one 2019-08, Vol.14 (8), p.e0220978
Main Authors: Mak, Victoria P., Siu, Andrea M., Choi, So Yung, Jun Ahn, Hyeong, Lim, Sian Yik
Format: Article
Language:English
Subjects:
Arthritis
Biology and Life Sciences
Emergency management
Emergency medical services
Gout
Health care
Health care facilities
Health care policy
Health services utilization
Hospitalization
Hospitals
Integrative medicine
Joint surgery
Medical records
Medical research
Medicine and Health Sciences
Osteoporosis
Patient admissions
Patients
People and Places
Population
Race
Rheumatic diseases
Rheumatism
Rheumatoid arthritis
Rheumatology
Trend analysis
Trends
Utilization
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Summary:Recent and comprehensive research of gout in the Pacific region and Hawai‘i is significantly lacking. This study was conducted to improve the understanding of the healthcare utilization of gout patients within a single health care system in Hawai‘i. The objective was to examine gout inpatient, outpatient and emergency department care within a single health care system in Hawai‘i. This study was a retrospective chart review of patients, ≥ 18 years admitted to three Hawai‘i Pacific Health facilities for a primary diagnosis of gout or rheumatoid arthritis (RA) from 2011 to 2017. Population data for the State of Hawai‘i was used to calculate visit rates per 1,000 Hawai‘i adults. Trend analysis was performed to compare changes over time. We studied gout health care utilization concurrently with RA to provide an internal comparison group for the healthcare utilization patterns of interest. Gout patients were primarily managed in the outpatient setting with high rates of emergency department visits. In contrast, RA patients were primarily managed in the outpatient setting, with low rates of emergency department visits. Both gout and RA patients had low rates of inpatient admissions. The cost of gout emergency department visits was approximately 3.4 times higher than gout outpatient visits. The rates for gout emergency department visits, outpatient visits, inpatients visits, and RA outpatient visits in 2017 were trending downward and significantly changed from 2011 (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0220978