Drs. Lai and Tsai contributed equally to this work.
Increased Frequency and Costs of Ambulatory Medical Care Utilization Prior to the Diagnosis of Rheumatoid Arthritis: A National Population-Based Study†
Article first published online: 24 FEB 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 3, pages 371–378, March 2014
How to Cite
Lai, N.-S., Tsai, T.-Y., Li, C.-Y., Koo, M., Yu, C.-L. and Lu, M.-C. (2014), Increased Frequency and Costs of Ambulatory Medical Care Utilization Prior to the Diagnosis of Rheumatoid Arthritis: A National Population-Based Study. Arthritis Care Res, 66: 371–378. doi: 10.1002/acr.22146
The interpretation and conclusion contained herein do not necessarily represent the positions of the Bureau of National Health Insurance, the Department of Health, or the National Health Research Institutes.
- Issue published online: 24 FEB 2014
- Article first published online: 24 FEB 2014
- Accepted manuscript online: 27 AUG 2013 03:28PM EST
- Manuscript Accepted: 20 AUG 2013
- Manuscript Received: 17 JAN 2013
- Dalin Tzu Chi Hospital
- Buddhist Tzu Chi Medical Foundation (DTCRD101-E-08), Taiwan
To investigate the frequency and costs associated with ambulatory medical care utilization over an 8-year period in patients prior to the diagnosis of rheumatoid arthritis (RA).
We used Taiwan's National Health Insurance Research Database to identify 691 newly diagnosed RA cases between 2005 and 2010. We selected 1,382 controls without RA, frequency matched by sex, age, and the catastrophic illness certificate application year of the cases. The frequency and costs of ambulatory medical care utilization between the RA patients and controls were compared using the 2-sample Kolmogorov-Smirnov test.
The median frequency of ambulatory medical care utilization was significantly higher in RA patients compared with controls (29 versus 13; P < 0.001) in the year before diagnosis. The differences remained significant throughout all 8 annual periods before diagnosis. Similarly, the inflation-adjusted costs of ambulatory medical care utilization in RA patients increased annually over the study period, from a median of $212 eight years preceding diagnosis to $798 one year preceding diagnosis. Frequency of ambulatory medical care utilization due to diseases of the musculoskeletal system and connective tissue (P < 0.001), acute respiratory infections (P < 0.001), diseases of the upper respiratory tract (P = 0.01), and diseases of the upper gastrointestinal tract (P = 0.04) were higher among RA patients in the 2-year period preceding diagnosis.
We found increased frequency and costs of ambulatory care utilization among RA patients in Taiwan preceding diagnosis of RA.