Gout and Risk of Hospital Admission for ACSCs

As defined by a study published in BMC Health Services Research, “Ambulatory Care Sensitive Conditions (ACSCs) are health conditions-diagnoses for which timely and effective outpatient care can help to reduce the risks of hospitalization by either preventing the onset of an illness or condition, controlling an acute episodic illness or condition, or managing a chronic disease.”

Optimal gout (a common form of inflammatory arthritis) management can be difficult to achieve in the majority of patients. The barriers to ideal gout therapy (including patient and health practitioner factors) have produced a complex effect. Treatment cycles of avoidance behaviors and recurrent hospitalizations for severe acute gout flares are the norm for some patients. A study published online in The Journal of Rheumatology investigated the risks and trajectories of hospital admission for ACSCs in patients diagnosed with gout, a common form of inflammatory arthritis.

Researchers identified patients without doctor-diagnosed gout during 1998 to 2005 (n=576,659). Patients were followed from 2006 until a hospital admission for an ACSC, death, or until the conclusion of the study’s data collection period in 2016. Utilizing Cox proportional and additive hazard models, researchers estimated the effects of gout on hospital admissions for ACSCs, using a new gout diagnosis as a time-varying exposure. In an age- and sex-matched cohort research and using generalized estimating equations, the trajectory of hospital admissions for ACSCs from 3 years before to 3 years after a gout diagnosis was further evaluated.

Gout was found to be associated with a 41% increased rate of hospital admission for ACSCs. This corresponds to 121 more hospital admissions for ACSCs per 10,000 person-years when compared with patients without gout. After performing a trajectory analysis, higher rates of hospital admission for ACSCs among persons with gout were observed from 3 years before to 3 years after diagnosis. Researchers identified three trajectories of hospital admissions for ACSCs among gout patients. The trajectories included almost no trajectory to hospital admission (88.5%), low to rising risk hospital admission (9.7%), and moderate to sharply rising trajectory to hospital admission (1.8%). Researchers concluded that “Increased risk of hospital admissions for ACSCs in gout highlights the need for better management of the disease through outpatient care, especially among foreign-born, older patients with comorbidities.”