A Strahl1, O Schneider2, J Frankenhauser-Mannuß2, S Knapstein2, C Hermann2, B Lembeck3, H-M Lorenz4,5, W Rüther1, J Flechtenmacher6,7. 1. Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Orthopädie, Martinistr. 52, 20246, Hamburg, Deutschland. 2. AOK Baden-Württemberg, Presselstr. 19, 70191, Stuttgart, Deutschland. 3. Orthopädisch-Unfallchirurgische Praxis Dr. Lembeck und Dr. Pampel, Hindenburgstr. 7/1, 73760, Ostfildern-Nellingen, Deutschland. 4. Medizinische Universitätsklinik V: Hämatologie, Onkologie, Rheumatologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland. 5. ACURA Rheumazentrum Baden-Baden, Rotenbachtalstr. 3-5, 76530, Baden-Baden, Deutschland. 6. Ortho-Zentrum - Orthopädische Gemeinschaftspraxis am Ludwigplatz, Waldstr. 67, 76133, Karlsruhe, Deutschland. flechtenmacher@ortho-zentrum.de. 7. Berufsverband für Orthopädie und Unfallchirurgie, Straße des 17. Juni 106-108, 10623, Berlin, Deutschland. flechtenmacher@ortho-zentrum.de.
Abstract
BACKGROUND: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population. OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services. MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013. RESULTS: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group. CONCLUSION: RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.
BACKGROUND:Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population. OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services. MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013. RESULTS: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RApatients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RApatients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group. CONCLUSION:RApatients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.
Entities:
Keywords:
Comorbidity; Health insurance data; Medical healthcare; Prevalence; Rheumatoid arthritis
Authors: Jürgen Braun; Klaus Krüger; Bernhard Manger; Matthias Schneider; Christof Specker; Hans Joachim Trappe Journal: Dtsch Arztebl Int Date: 2017-03-24 Impact factor: 5.594
Authors: Celina Alves; Jolanda Jacoba Luime; Derkjen van Zeben; Anne-Margriet Huisman; Angelique Elisabeth Adriana Maria Weel; Pieternella Johanna Barendregt; Johanna Maria Wilhelmina Hazes Journal: Ann Rheum Dis Date: 2011-05-27 Impact factor: 19.103