Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study

Abstract

BACKGROUND:Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan.METHODS:The National Health Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged ≥16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS.RESULTS:The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054).CONCLUSION:Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted.

Ankylosing spondylitis and the risk of cancer

“…Based on clinical practice and epidemiology, AS is considered to be a male-predominant disease (2). Thus, identifying gender differences in cancer development may affect treatment policies for clinical practice.…”

“…All subjects who received a cancer diagnosis (ICD9-CM codes 140-208) were confirmed by following up from the first diagnosis to their regular treatment. In most cases, patients who receive a cancer diagnosis typically undergo regularly scheduled treatment such as surgery, radiotherapy, chemotherapy and/or drug therapy (2,(14)(15)(16).…”

“…AS is a human leucocyte antigen (HLA)-B27-related joint disorder that predominantly affects adolescent men and initially presents as lower back pain (1,2). More than 90% of Chinese AS patients are HLA-B27 positive, with the predominant subtype being HLA-B * 2704 (3).…”

The Distribution of HLA B27 in Patients with Ankylosing Spondylitis in Eastern Anatolia

“…An alternative explanation may be that women's who live in this area using health services less or less hospital admissions. 17 In conclusion, although role of HLA B27 in AS etiology has not been fully understood, literature data about HLA B27 positive patients in our country is limited. This study revealed that HLA B27 prevalence in our study is different from the ratio of other study.…”

Relative risk of end-stage renal disease requiring dialysis in treated ankylosing spondylitis patients compared with individuals without ankylosing spondylitis: A nationwide, population-based, matched-cohort study

“…Ankylosing spondylitis (AS) is a common immune-mediated inflammatory rheumatic disease affecting 0.11%-0.38% of the Taiwanese population [1,2]. It is characterized by chronic spinal pain, stiffness, fatigue and progressive spinal ankylosis.…”