Trends in the first decade of 21st century healthcare utilisation in a rheumatoid arthritis cohort compared with the general population
- Sofia Hagel1,
- Ingemar F Petersson2,
- Ann Bremander1,3,
- Elisabet Lindqvist1,
- Charlotte Bergknut2,
- Martin Englund2,4
- 1Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
- 2Department of Orthopedics, Lund University, Lund, Sweden
- 3School of Business and Engineering, Department of Exercise Physiology, Biomechanics and Health, Halmstad University, Halmstad, Sweden
- 4Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
- Correspondence to Sofia Hagel, Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, SE-221 85 Lund, Sweden;
- Received 27 August 2012
- Revised 12 October 2012
- Accepted 18 November 2012
- Published Online First 8 December 2012
Purpose To study 21st century trends in healthcare utilisation by patients with rheumatoid arthritis (RA) compared with the general population.
Methods Observational cohort study. Using Swedish healthcare register data, we identified 3977 Region Skåne residents (mean age in 2001, 62.7 years; 73% women) presenting with RA (International Classification of Diseases-10 codes M05 or M06) in 1998–2001. We randomly sampled two referents from the general population per RA patient matched for age, sex and area of residence. We calculated the year 2001–2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalisations and outpatient clinic visits.
Results By the end of the 10-year period, 62% of patients and 74% of referents were still alive and resident in the region. From 2001 to 2010, the ratio (RA cohort/referents) of the mean number of hospitalisations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005) and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy. The absolute reduction in number of hospitalisations was from an annual mean of 0.79 to 0.69 in male patients and from 0.71 to 0.59 in female patients. The corresponding annual mean number of consultations in outpatient physician care by male and female RA patients changed from 9.2 to 7.7 and from 9.9 to 8.7, respectively.
Conclusions During the first decade of the 21st century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, overall inpatient and outpatient healthcare utilisation by a cohort of patients with RA decreased relative to the general population.