Increased Frequency and Costs of Ambulatory Medical Care Utilization Prior to the Diagnosis of Rheumatoid Arthritis: A National Population-Based Study
Resource
Arthritis Care Res., 66(3), 371-378
Journal
Arthritis Care Res.
Journal Volume
66
Journal Issue
3
Pages
371-378
Date Issued
2014
Date
2014
Author(s)
Abstract
ObjectiveTo investigate the frequency and costs associated with ambulatory medical care utilization over an 8-year period in patients prior to the diagnosis of rheumatoid arthritis (RA).
MethodsWe used Taiwan's National Health Insurance Research Database to identify 691 newly diagnosed RA cases between 2005 and 2010. We selected 1,382 controls without RA, frequency matched by sex, age, and the catastrophic illness certificate application year of the cases. The frequency and costs of ambulatory medical care utilization between the RA patients and controls were compared using the 2-sample Kolmogorov-Smirnov test.
ResultsThe median frequency of ambulatory medical care utilization was significantly higher in RA patients compared with controls (29 versus 13; P < 0.001) in the year before diagnosis. The differences remained significant throughout all 8 annual periods before diagnosis. Similarly, the inflation-adjusted costs of ambulatory medical care utilization in RA patients increased annually over the study period, from a median of $212 eight years preceding diagnosis to $798 one year preceding diagnosis. Frequency of ambulatory medical care utilization due to diseases of the musculoskeletal system and connective tissue (P < 0.001), acute respiratory infections (P < 0.001), diseases of the upper respiratory tract (P = 0.01), and diseases of the upper gastrointestinal tract (P = 0.04) were higher among RA patients in the 2-year period preceding diagnosis.
ConclusionWe found increased frequency and costs of ambulatory care utilization among RA patients in Taiwan preceding diagnosis of RA.
SDGs
Other Subjects
adult; ambulatory care; appendicitis; article; chronic obstructive lung disease; colitis; connective tissue disease; controlled study; digestive system disease; duodenum disease; enteritis; enteropathy; esophagus disease; female; gallbladder disease; health care cost; health care utilization; hepatobiliary disease; hernia; human; influenza; jaw disease; liver disease; lung disease; major clinical study; male; medical care; middle aged; mouth disease; musculoskeletal disease; peritoneal disease; pneumoconiosis; pneumonia; respiratory tract infection; rheumatoid arthritis; salivary gland disease; stomach disease; Taiwan; Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Care; Arthritis, Rheumatoid; Female; Health Care Costs; Humans; Male; Middle Aged; Retrospective Studies; Taiwan; Young Adult