Health care utilization in patients with spondyloarthropathies.
OBJECTIVE
To study health care utilization in veterans with SpAs.


METHODS
In a postal survey of 70,508 veterans in Veterans Integrated Service Network (VISN)-13 from 1 October 1996 to 31 March 1998, demographics, smoking status and performance of activities of daily living (ADLs) were queried. Databases provided ICD-9 codes for AS, PsA and ReA; comorbidities; demographics; and health care utilization post-survey in respondents. Multivariable linear/logistic regression compared out- and inpatient health care utilization in SpA vs non-SpA, and its predictors in SpA.


RESULTS
A total of 1001 veteran respondents had diagnoses of SpA: AS, n = 154; PsA, n = 814; ReA, n = 33. Veterans with AS, PsA and ReA, respectively, had significantly higher adjusted annual medical specialty (2.8, 3.6 and 3 vs 1.5; P < 0.0001), surgical care (3.3, 2.7 and 3.2 vs 1.9; P < 0.0001) and primary care visits (3.4, 3.0 and 2.3 vs 2.7, P = 0.024). Multivariable-adjusted analyses showed that more ADL limitations and higher comorbidity were associated with higher in- and outpatient health care utilization in PsA and none of the predictors were significantly associated with utilization in AS.


CONCLUSIONS
After adjustment for differences in demographics and comorbidities, more outpatient health resource utilization was observed in SpA patients. Further studies should focus on what leads to this increase in utilization, and whether any modifiable factors can be introduced to reduce health care utilization in PsA patients.
Singh
J A
JA
Rheumatology Section, Medicine Service, VA Medical Center, Minneapolis, MN 55417, USA. Jasvinder.md@gmail.com
Strand
V
V
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology / Q000628:therapy; D016918:Arthritis, Reactive / Q000453:epidemiology / Q000628:therapy; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006302:Health Services Research / Q000379:methods; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D000091402:Prohibitins; D025242:Spondylarthropathies / Q000453:epidemiology / Q000628:therapy*; D013167:Spondylitis, Ankylosing / Q000453:epidemiology / Q000628:therapy; D014481:United States / Q000453:epidemiology