The Effect of Serum Urate on Gout Flares and Their Associated Costs An Administrative Claims Analysis
The Effect of Serum Urate on Gout Flares and Their Associated Costs An Administrative Claims Analysis
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DOI：
10.1097/rhu.0b013e3181945d2c
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发表时间：
2009-01-01
影响因子：
3.4
通讯作者：
Mikuls, Ted R.
中科院分区：
文献类型：
--
作者：
Halpern, Rachel;Fuldeore, Mahesh J.;Mikuls, Ted R.
背景：血清尿酸（sUA）水平升高（>= 6.0 mg/dL）与急性痛风发作或“发作”的可能性增加相关。“目标：通过行政索赔数据识别痛风耀斑；检查sUA和耀斑之间的关系；检查sUA与火炬相关成本之间的关系。方法：本回顾性行政索赔分析检查了ICD-9-CM诊断代码为274的痛风（>= 2）医疗索赔。在2002年1月1日至2004年3月31日期间，xx或>= 1的痛风诊断索赔和>= 1的别嘌呤醇、丙苯酸、秋水仙碱或磺胺吡嗪的药房索赔。每位受试者在1年的基线期和1年的随访期进行观察。通过使用与耀斑相关的服务索赔的算法识别痛风耀斑。结果是sUA （mg/dL）和与耀斑相关的医疗费用。Logistic回归检验了耀斑发生的可能性；广义线性模型回归测量了基线sUA对火炬成本的影响，控制了人口和健康状况变量。结果：研究样本包括18243名受试者，平均年龄53.9岁。4277例（23%）受试者可获得sUA。62%（11,253）的受试者有>= 1耀斑。平均的、未调整的耀斑数量随着sUA的增加而增加。Logistic结果显示受试者基线sUA >= 6.0相对于sUA
Background: Increased serum urate (sUA) levels (>= 6.0 mg/dL) are associated with increased likelihood of acute gout attacks, or "flares."Objectives: Identify gout flares with administrative claims data; examine the relationship between sUA and flares; examine the association between sUA and flare-related costs.Methods: This retrospective administrative claims analysis examined subjects with gout (>= 2 medical claims with ICD-9-CM diagnosis code 274.xx or >= 1 claim with a gout diagnosis and >= 1 pharmacy claim for allopurinol, probenecid, colchicine, or sulfinpyrazone) between January 1, 2002 and March 31, 2004. Each subject was observed during 1-year baseline and 1-year follow-up periods. Gout flares were identified with an algorithm using claims for services associated with flares. Outcomes were sUA (mg/dL) and flare-related health care costs. Logistic regression examined the likelihood of flare; generalized linear modeling regression measured the impact of baseline sUA on flare costs, controlling for demographic and health status variables.Results: The study sample comprised 18,243 subjects with mean age of 53.9 years. sUA was available for 4277 (23%) subjects. Sixty-two percent (11,253) of subjects had >= 1 flare. The number of mean, unadjusted flares increased with sUA. Logistic results showed subjects with baseline sUA >= 6.0 relative to sUA