Matthew J Koster1,2, Sara J Achenbach3,4, Cynthia S Crowson3,4, Hilal Maradit-Kremers3,4, Eric L Matteson3,4, Kenneth J Warrington3,4. 1. From the Department of Internal Medicine, Division of Rheumatology; Department of Health Sciences Research, Division of Biomedical Statistics and Informatics; Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA. koster.matthew@mayo.edu. 2. M.J. Koster, MD, Department of Internal Medicine, Division of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic; C.S. Crowson, MS, Department of Internal Medicine, Division of Rheumatology, and Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic; H. Maradit-Kremers, MD, MSc, Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic; E.L. Matteson, MD, MPH, Department of Internal Medicine, Division of Rheumatology, and Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic; K.J. Warrington, MD, Department of Internal Medicine, Division of Rheumatology, Mayo Clinic. koster.matthew@mayo.edu. 3. From the Department of Internal Medicine, Division of Rheumatology; Department of Health Sciences Research, Division of Biomedical Statistics and Informatics; Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA. 4. M.J. Koster, MD, Department of Internal Medicine, Division of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic; C.S. Crowson, MS, Department of Internal Medicine, Division of Rheumatology, and Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic; H. Maradit-Kremers, MD, MSc, Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic; E.L. Matteson, MD, MPH, Department of Internal Medicine, Division of Rheumatology, and Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic; K.J. Warrington, MD, Department of Internal Medicine, Division of Rheumatology, Mayo Clinic.
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.
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.
Entities:
Keywords:
COST; GIANT CELL ARTERITIS; HEALTHCARE USE
Authors: Clement John Michet; Sara J Achenbach; Cynthia S Crowson; Eric L Matteson Journal: Semin Arthritis Rheum Date: 2015-03-03 Impact factor: 5.532
Authors: M A González-Gay; R Blanco; V Abraira; C García-Porrúa; D Ibáñez; M J García-Pais; M T Rigueiro; A Sánchez-Andrade; J Guerrero; E Casariego Journal: J Rheumatol Date: 1997-11 Impact factor: 4.666
Authors: A Chandran; Pr D Udayakumar; T A Kermani; K J Warrington; C S Crowson; E L Matteson Journal: Clin Exp Rheumatol Date: 2015-05-26 Impact factor: 4.473