003 - The impact of COVID-19 on hospital utilization for patients with gout

During the COVID-19 pandemic, there was a dramatic decrease in the percentage of patients admitted to the hospital through the emergency department. One study showed a 32% decrease in admissions from March 3, 2020, through September 8, 2020 (Nourazari, et al. 2021). The decreased hospitalizations affect patients' access to treatment for chronic conditions, such as gout.

Gout is a common hyperuricemic metabolic condition that leads to recurrent inflammatory arthritis and subsequently severe pain. High uric acid levels can form tiny crystals that lodge in joints, as well as accumulate in the kidneys, causing kidney stones. Patients affected by this condition experience a higher prevalence of metabolic syndrome and risk of cardiometabolic comorbidities (Choi, et al. 2022). According to a Global Burden of Disease analysis of 195 countries and territories from 1990 to 2017, the incidence, prevalence, and disability burden of gout have all increased worldwide in recent decades. In 2016, gout affected more than 9.2 million US adults (Chen, 2019).

Hospitalizations and emergency room visits related to the treatment of gout have increased over the past two decades. US hospitalization rates due to gout doubled from 1993 to 2011 (Lim, et al. 2016). From 2009 to 2012 alone, annual ED visits for gout in the US increased from 180,789 to 205,152 (Singh & Yu, 2016).

The COVID-19 pandemic had an impact on hospital utilization and how patients received care for chronic conditions such as gout. To better understand the impact of COVID-19 on hospital utilization and care received for gout, this study will use the National Hospital Care Survey (NHCS) to analyze hospital admissions and emergency department care data for patients with gout during 2020 and 2021.

NHCS is an annual administrative data collection of a year of inpatient and emergency department encounter-level data from a sample of non-institutional and non-federal hospitals with six or more staffed inpatient beds. NHCS provides statistics on health care utilization and care to answer key questions of interest to public health professionals, researchers, and health care policy makers. NHCS data are unweighted and are not nationally representative.

To meet the need for hospital data during the COVID-19 pandemic, NHCS released preliminary 2020 and 2021 inpatient and emergency department data from approximately 50 hospitals to develop a NHCS COVID-19 dashboard reporting on hospital care related to COVID-19. The preliminary NHCS data are not nationally representative, but exploratory analysis of hospital care can be used to provide insight on emerging health care trends. In the preliminary NHCS data from January 2020 through December 2021, there were 30,157 inpatient admissions and 34,376 emergency department visits for patients with a diagnosis of gout. This study will present an overview of the hospital admissions and emergency visits concerning gout during the COVID-19 pandemic, highlighting changes of gout-related hospital utilization compared to increases in COVID-19 hospitalizations. These data demonstrate the impact of COVID-19 on the treatment of chronic conditions, such as gout flares.

References:
Choi, H.K., et al. Excess comorbidities in gout: the causal paradigm and pleiotropic approaches to care. (2022).

Nourazari S, et al. Decreased hospital admissions through emergency departments during the COVID-19 pandemic. Am J Emerg Med. 2021

Lim SY, Lu N, Oza A et al. Trends in gout and rheumatoid arthritis hospitalizations in the United States, 1993–2011. JAMA 2016;315:2345–7.

Chen-Xu, M., et al. (2019), Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007–2016

Singh JA, Yu S. Time Trends, Predictors, and Outcome of Emergency Department Use for Gout: A Nationwide US Study. J Rheumatol. 2016 Aug

Hospital utilization

Gout

Chronic conditions

COVID-19 

Mid-Level

Knowledge

International Conference on Health Policy Statistics 2023