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

Mak, Victoria P.; Siu, Andrea M; Choi, So Yung; Ahn, Hyeong Jun; Lim, Sian Yik

doi:10.1371/journal.pone.0220978

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…25 A prior study by Mak et al showed that gout care in Hawaiʻi is suboptimal, with a high number of emergency department visits compared to rheumatoid arthritis. 27 The current study supports these findings, as evidenced by suboptimal serum urate in both Native Hawaiian patients and White patients. Furthermore, the results from the current study describe a difference in emergency department and outpatient visits between Native Hawaiian and White patients, suggesting a disparity in care between the two groups.…”

Section: Discussionsupporting

confidence: 85%

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Gout in Native Hawaiian Patients in Hawaiʻi: Clinical Characteristics and Disparities

Chang,

Siu,

Kimata

et al. 2024

Arthritis Care & Research

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ObjectiveTo investigate differences in clinical characteristics and healthcare utilization of Native Hawaiian and White gout patientsMethodsWe performed a retrospective chart review of Native Hawaiian and White gout patients treated from 2011‐2017 within a large healthcare system in Hawai'i. We compared demographic characteristics, clinical outcomes, and risk factors for gout. We used multivariable logistic regression to identify predictive factors of emergency department visits.ResultsWe identified 270 Native Hawaiian gout patients and 239 White patients. The Native Hawaiian patients were younger on average (54.0 vs. 64.0, p<0.0001) and had an earlier onset of disease (50.0 vs. 57.0, p<0.0001). Native Hawaiian gout patients had higher mean (7.58 vs. 6.87, p<0.0001) and maximum (10.30 vs. 9.50, p<0.0001) serum urate levels as compared to White gout patients. Native Hawaiian gout patients also had a greater number of tophi (median 2.00 vs. 1.00, p<0.0001). Native Hawaiians gout patients were 2.7 times more likely to have frequent (≥ 1) emergency department visits than White gout patients. Native Hawaiian gout patients were less likely to have a therapeutic serum urate ≤ 6.0 and had lower rates of rheumatology specialty care.ConclusionNative Hawaiian patients have a higher disease burden of gout, with earlier disease onset and more tophi. Native Hawaiian gout patients are more likely to use emergency services for gout, had lower rates of rheumatology specialty care compared to white patients. Future studies are needed to promote culturally appropriate preventive care and management of gout in Native Hawaiians.This article is protected by copyright. All rights reserved.

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Section: Discussionsupporting

confidence: 85%

“…A prior study by Mak et al showed that gout care in Hawaiʻi is suboptimal, with a high number of emergency department visits compared to rheumatoid arthritis 27 . The current study supports these findings, as evidenced by suboptimal serum urate in both Native Hawaiian patients and White patients.…”

Section: Discussionsupporting

confidence: 85%

Gout in Native Hawaiian Patients in Hawaiʻi: Clinical Characteristics and Disparities

Chang,

Siu,

Kimata

et al. 2024

Arthritis Care & Research

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“…The increase was most pronounced (29%) in those aged 45 to 54 years. On the other hand, a study within a single healthcare system in Hawaii reported that the rates of gout ED visits in 2017 trended downward and that they had significantly decreased since 2011 [ 10 ]. The rates of RA outpatient visits, which were used as an internal comparison group, also decreased in 2017, as did the rates of outpatient and inpatient visits for gout.…”

Section: Discussionmentioning

confidence: 99%

“…We plan to examine the factors associated with ED visits for gout patients in a future study, which would elucidate possible choices for optimization of treatment of gout and guide policy decisions. Many studies have addressed the prevalence of ED visits for gout in Western countries [ 2 , 5 , 10 , 18 – 20 ], but very little research has been carried out in Asian countries. The present study was the first to analyze hospital visits due to gout in Korea.…”

Section: Discussionmentioning

confidence: 99%

Trends in hospital visits and healthcare costs of gout and seropositive rheumatoid arthritis in Korea from 2010 to 2017 using National Healthcare Claims

Kim

Park

et al. 2022

Korean J Intern Med

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Background/Aims: We examined temporal trends in the rate of gout and seropositive rheumatoid arthritis (RA) hospital visits and healthcare costs in Korea. Methods: We conducted a serial cross-sectional analysis of Korean national healthcare claims. We calculated the annual increase in hospital visits (emergency department [ED] visits, outpatient visits, and hospitalizations) and total healthcare costs per visit. Results: From 2010 to 2017, the annual rates of ED visits, outpatient visits, and hospitalizations for gout increased from 6.28 to 21, from 638.38 to 1059.55, and from 12.37 to 15.6 per 100,000 persons, respectively. Before 2013, ED visits for gout were most common in patients over 70 years old, but they were most common in those aged between 30 and 49 years after 2013. The number of patients with ED visits, outpatient visits, and hospitalizations for RA from 2010 to 2017 increased from 1.25 to 1.87, from 219.04 to 307.49 and from 8.44 to 12.32 per 100,000 persons, respectively. However, there was no increase in the prevalence of ED visits for RA in any age group except for those older than 70 years. The cost per ED visit for gout significantly decreased from 496.3 to 273.6 US dollar during the study period. There was no significant change in the cost per ED visit for RA between 2010 and 2017. Conclusions: There was a large increase in ED visits for gout during the study period.Further studies are needed to analyze the reason behind increased ED visits for gout and suggest ways on how to improve gout care.

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related quality of life (HRQoL), moderate disability (21.1%), as well as a higher cost of emergency visits. 2,4 In the US population-based cohort, older adults with gout, were more likely to have poor lower extremity function, consistent with the most common localization of affected joints. Older adults with gout were 1.18-times more likely to have poor SPPB (Short Physical Performance Battery) scores and 1.19-times more likely to have poor walking speed.

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confidence: 87%

Community gout management program needed for adult people in the rural area

Madyaningrum

Kusumaningrum

Wardani

et al. 2021

J Community Empowerment for Health

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Gout is one of the non-communicable diseases that can affect the quality of life. The high prevalence of gout is apparent in Indonesian research and records in primary health services. However, adult people's needs regarding gout management programs were barely explored. The study aimed to identify the association between the character of demographics, food consumption, and prevalence of gout in the rural areas in The Sleman Regency. This study is a quantitative study using a cross-sectional approach. Samples consisting of 109 adult people were chosen by purposive sampling with inclusion criteria: 1) residents of The Jaranan sub-village, Cangkringan, Sleman, D.I. Yogyakarta Province and 2) age over 25 years old. Data was collected through a survey using questionnaires adapted from the Indonesian Basic Health Survey Questionnaire, Gout Knowledge Questionnaire (GKQ) and Gout Assessment Questionnaire (GAQ), and food frequency form. Association between gout, food consumption, and knowledge were analyzed using the chi-square test.As a result, the prevalence of gout in adult people in rural areas was 18.35%. They have limited knowledge regarding gout diagnosis, treatment, and prevention (66,97%). Half of the respondents reported consuming food with medium content of purine such as tempeh (56%) and tofu (52%), and were not well-hydrated (63.3%). There was a significant relationship between gout and hypertension and meat consumption. Respondents reported they worried about the progress of gout (>70%) they will experience. In conclusion, the prevalence of gout is high in adult people in rural areas. The adult people who did not have formal education, hypertension, and meat consumption have a significant association with gout diseases. There is a need for a gout prevention program to maintain a healthy lifestyle and healthy diet, improve gout-related knowledge and control the progress of gout disease.

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

Cited by 3 publications

References 26 publications

Gout in Native Hawaiian Patients in Hawaiʻi: Clinical Characteristics and Disparities

Gout in Native Hawaiian Patients in Hawaiʻi: Clinical Characteristics and Disparities

Trends in hospital visits and healthcare costs of gout and seropositive rheumatoid arthritis in Korea from 2010 to 2017 using National Healthcare Claims

Community gout management program needed for adult people in the rural area

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