Hospital Burden of Chronic Gout with and without Tophus Insured By Medicaid: A Propensity Score Matched Analysis of in-Patient Claims Database
Author(s)
Aggarwal S1, Bela A1, Kumar S2, Topaloglu H1
1NOVEL Health Strategies, Chevy Chase, MD, USA, 2NOVEL HEALTH STRATEGIES, COLUMBIA, MD, USA
OBJECTIVES: To examine trends in hospital length of stay, total costs and comorbidities in chronic Gout patients with and without tophus insured by Medicaid. METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for Medicaid patients with chronic gout (w/o tophus). Propensity score matched analysis was conducted to compare hospital LOS and costs in patients w/o tophus. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs. RESULTS: In 2016, there were an estimated 3140 hospitalizations with a diagnosis of chronic gout, of which 27% were with tophus. The mean age was 54.53 (SD 11.24) and 54.47 (SD 11.4) years and 89% and 71% were male in chronic gout with and without tophus groups, respectively. The overall comorbidity index in all chronic gout patients (with or without tophus) was 4.6 (SD 2.28). Most common comorbidities were Renal Failure (42%), Complicated Hypertension (42%) and Congestive Heart Failure (35%). The propensity score matched hospital LOS was 6.9 and 4.6, with a statistically significant difference of 2.2 days (SE 1.01, P<0.05), in chronic gout with and without tophus, respectively. The propensity score matched hospital charges were $57,212 and $44,228, with a statistically significant difference of $12,923 (SE $10989, P<0.05), in chronic gout with and without tophus, respectively. CONCLUSIONS: Medicaid chronic gout patients with or without tophus suffer from high rate of comorbidities leading to long hospital length of stay and high costs. The chronic gout patients with tophus have relatively higher burden of hospitalizations compared to patients without tophus.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PDB12
Topic
Economic Evaluation
Disease
Diabetes/Endocrine/Metabolic Disorders