Sicras-Mainar Antoni, Navarro-Artieda Ruth, Ibáñez-Nolla Jordi
Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España.
Reumatol Clin. 2013 Mar-Apr;9(2):94-100. doi: 10.1016/j.reuma.2012.06.014. Epub 2013 Jan 10.
To determine the use of resources and economic impact of patients with gout at the population level.
Observational design analysing records belonging to 6 primary care centers and 2 hospitals. We included patients' ≥18 years with an acute episode of gout over the years 2003-2007. Patient follow-up was 2 years. It produced two study groups: patients with 1-2 attacks/acute recurrences and 3 or more events. Main variables were: demographic, co-morbidity, metabolic syndrome (MS), and resource use and health/non-health costs.
logistic regression-model ANCOVA, P<.05.
3,130 patients with gout were included. Prevalence: 3.3%, mean age: 55.8 years male: 81.1%. Groups were distributed as follows: 68.4% had 1-2 acute attacks and 31.6% with 3 or more, P<.001. The prevalence of MS was 28.8% (confidence interval [CI] 95% CI 27.2 to 30.4%). The average/unit cost was € 2,228.6 (direct costs: 96.9%), 90.8% in primary care (visits: 23.5%; drugs: 57.7%). For groups, the average corrected model/unit total cost per patient was € 2,130.6 vs. € 2,605.4, respectively (P<.001). In all cost components, the results were higher in the group with ≥ 3 attacks. The subgroup of diabetic patients (N=641, 20.5%) had a higher cost (€ 3,124.8€ vs. € 1,997.8, P<.001).
Gout is associated with substantial morbidity, presence of MS and resource consumption. The study provides useful data on the cost of the disease; the costs of outpatient follow up is the highest.
确定痛风患者在人群层面的资源利用情况和经济影响。
采用观察性设计，分析6个初级保健中心和2家医院的记录。纳入2003年至2007年间≥18岁且有痛风急性发作的患者。对患者进行2年随访。由此产生两个研究组：1 - 2次发作/急性复发的患者和3次及以上发作的患者。主要变量包括：人口统计学特征、合并症、代谢综合征（MS）以及资源利用和健康/非健康成本。
逻辑回归模型、协方差分析，P <.05。
纳入3130例痛风患者。患病率：3.3%，平均年龄：55.8岁，男性：81.1%。分组情况如下：68.4%的患者有1 - 2次急性发作，31.6%的患者有3次及以上发作，P <.001。MS的患病率为28.8%（95%置信区间[CI]为27.2%至30.4%）。平均/单位成本为2228.6欧元（直接成本：96.9%），其中90.8%用于初级保健（就诊：23.5%；药物：57.7%）。对于两个组，每位患者的平均校正模型/单位总成本分别为2130.6欧元和2605.4欧元（P <.001）。在所有成本构成中，发作≥3次的组结果更高。糖尿病患者亚组（N = 641，20.5%）成本更高（3124.8欧元对1997.8欧元，P <.001）。
痛风与高发病率、MS的存在以及资源消耗相关。该研究提供了关于该疾病成本的有用数据；门诊随访成本最高。
