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Gout in the elderly - A population health study
Journal of Rheumatology, 04/10/09

Hanly JG et al. – Study reports that gout is associated with a high disease burden in older men and women; cost primarily attributable to hospitalization, due to the comorbidities associated with gout. As the majority of cases are managed by nonrheumatologists, it is important that guidelines for the diagnosis and treatment of gout are disseminated to and met by all physician groups

• Aim was to determine the incidence, healthcare utilization, and costs in older adults with gout
• A 5-yr retrospective case-control study of pts with incident gout and matched controls
• Study variables were derived from health administrative data and included:
  • patient demographics
  • International Classification of Diseases diagnostic codes
  • and healthcare cost information

• 4,071 cases and 16,281 controls, provided a 5-yr incidence of gout of 4.4%
• Gout was diagnosed by family physicians (77%), nonrheumatology subspecialists (18%), general internists (4%), and rheumatologists (0.02%)
• Hospitalizations were higher in cases in the year of diagnosis
• Pts with gout had an average of 28.1 physician visits/yr vs 20.6 for controls
• Drug utilization for the treatment and prevention of gout was higher
• The average healthcare cost differential was +$134 (Cdn)/mo, and +$8,020/case over 5 yrs
• These costs were due to hospital utilization (64.4%), medications (23.1%), and physician visits (12.5%)

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