Patients with Axial Spondyloarthritis are Great Consumers of Healthcare Resources, Especially Young and Women: Results from the Spanish Atlas

Rheumatol Ther. 2023 Jun;10(3):729-739. doi: 10.1007/s40744-023-00543-3. Epub 2023 Mar 6.

Abstract

Introduction: This study aimed to assess high healthcare utilization over 1 year in patients with axial spondyloarthritis (axSpA) and factors associated with increased healthcare utilization.

Methods: A total of 530 unselected patients with axSpA from the Atlas of Axial Spondyloarthritis in Spain-who had used at least one healthcare resource-were included in the present study. Total health care utilization was obtained from the total number of healthcare visits, medical tests, hospital admissions and emergency visits, during the 12 months prior to the survey. Linear regression was used to analyse possible factors associated with higher healthcare utilization.

Results: A total of 530 patients with axSpA participated in this study: mean age was 45.3 years and 51.1% were female. In the previous 12 months, 77.9% (n = 530) used at least one healthcare resource, with the median healthcare utilization at 25. In the multiple linear regression, the only categorical factor associated with higher healthcare utilization was female gender (β = 12.854), while the continuous factors associated with higher healthcare utilization were higher disease activity (β = 3.378), longer diagnostic delay (β = 0.959), younger age (β = - 0.737) and greater functional limitation (β = 0.576).

Conclusion: Half of patients with axSpA used 25 or more healthcare resources during 1 year. Higher healthcare utilization was associated with younger age, female gender, greater disease activity, higher functional limitation and longer diagnostic delay. Optimal monitoring of patients with axSpA may help to reduce their healthcare utilization.

Keywords: Axial spondyloarthritis; Diagnostic delay; Gender differences; Healthcare utilization.