Healthcare use and direct cost of giant cell arteritis: A population-based study

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Abstract

Objective. To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. Methods.A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982-2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987-2014 and outpatient use data for 1995-2014 were obtained. Use and costs were compared between cohorts through signed-rank paired tests, McNemar's tests, and quantile regression models. Results. Significant annual differences in outpatient costs were observed for patients with GCA in each of the first 4 years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared with matched referent subjects, patients with GCA had higher use of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0-1, 1-2, and 3-4. Patients with GCA had significantly more radiology visit-days in years 0-1, 3-4, and 4-5, and more ophthalmologic procedures/surgery in years 0-1, 1-2, 2-3, and 4-5 compared to non-GCA. Emergency medicine visits, musculoskeletal, and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period. Conclusion. Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher use of outpatient physician, laboratory, and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.

Original languageEnglish (US)
Pages (from-to)1044-1050
Number of pages7
JournalJournal of Rheumatology
Volume44
Issue number7
DOIs
StatePublished - Jul 1 2017

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Giant Cell Arteritis
Delivery of Health Care
Costs and Cost Analysis
Outpatients
Population
Arteritis
Radiology
Physicians
Emergency Medicine
Economic Inflation
Incidence

Keywords

  • Cost
  • Giant cell arteritis
  • Healthcare use

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

@article{5ad5699449fc4637a0e94e7370f4733b,
title = "Healthcare use and direct cost of giant cell arteritis: A population-based study",
abstract = "Objective. To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. Methods.A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982-2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987-2014 and outpatient use data for 1995-2014 were obtained. Use and costs were compared between cohorts through signed-rank paired tests, McNemar's tests, and quantile regression models. Results. Significant annual differences in outpatient costs were observed for patients with GCA in each of the first 4 years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared with matched referent subjects, patients with GCA had higher use of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0-1, 1-2, and 3-4. Patients with GCA had significantly more radiology visit-days in years 0-1, 3-4, and 4-5, and more ophthalmologic procedures/surgery in years 0-1, 1-2, 2-3, and 4-5 compared to non-GCA. Emergency medicine visits, musculoskeletal, and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period. Conclusion. Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher use of outpatient physician, laboratory, and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.",
keywords = "Cost, Giant cell arteritis, Healthcare use",
author = "Matthew Koster and Achenbach, {Sara J.} and Cynthia Crowson and {Maradit Kremers}, {Hilal D} and Matteson, {Eric Lawrence} and Warrington, {Kenneth J}",
year = "2017",
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doi = "10.3899/jrheum.161516",
language = "English (US)",
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TY - JOUR

T1 - Healthcare use and direct cost of giant cell arteritis

T2 - A population-based study

AU - Koster, Matthew

AU - Achenbach, Sara J.

AU - Crowson, Cynthia

AU - Maradit Kremers, Hilal D

AU - Matteson, Eric Lawrence

AU - Warrington, Kenneth J

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective. To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. Methods.A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982-2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987-2014 and outpatient use data for 1995-2014 were obtained. Use and costs were compared between cohorts through signed-rank paired tests, McNemar's tests, and quantile regression models. Results. Significant annual differences in outpatient costs were observed for patients with GCA in each of the first 4 years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared with matched referent subjects, patients with GCA had higher use of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0-1, 1-2, and 3-4. Patients with GCA had significantly more radiology visit-days in years 0-1, 3-4, and 4-5, and more ophthalmologic procedures/surgery in years 0-1, 1-2, 2-3, and 4-5 compared to non-GCA. Emergency medicine visits, musculoskeletal, and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period. Conclusion. Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher use of outpatient physician, laboratory, and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.

AB - Objective. To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. Methods.A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982-2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987-2014 and outpatient use data for 1995-2014 were obtained. Use and costs were compared between cohorts through signed-rank paired tests, McNemar's tests, and quantile regression models. Results. Significant annual differences in outpatient costs were observed for patients with GCA in each of the first 4 years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared with matched referent subjects, patients with GCA had higher use of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0-1, 1-2, and 3-4. Patients with GCA had significantly more radiology visit-days in years 0-1, 3-4, and 4-5, and more ophthalmologic procedures/surgery in years 0-1, 1-2, 2-3, and 4-5 compared to non-GCA. Emergency medicine visits, musculoskeletal, and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period. Conclusion. Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher use of outpatient physician, laboratory, and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.

KW - Cost

KW - Giant cell arteritis

KW - Healthcare use

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