Increasing Public Health Burden of Arthritis and Other Rheumatic Conditions and Comorbidity: Results From a Statewide Health Surveillance System, 2007-2012.

OBJECTIVE: To describe the burden and changing trends of arthritis and other rheumatic conditions (AORCs) on health care and public health by estimating annual rates of emergency department (ED) visits, hospitalizations, and mortality, in addition to medical charges related to AORCs and their comorbidities in Nebraska from 2007 to 2012.

METHODS: Nebraska state ED discharge, hospital discharge, and death certificate data from 2007 to 2012 were used to estimate disease burden. AORCs were defined using the standard International Classification of Diseases specified by the National Arthritis Data Workgroup. AORC conditions were defined by the presence of a diagnostic code anywhere on the corresponding record. To identify potential disparities in AORC burden, health care utilization was examined separately across 4 urban/rural categories.

RESULTS: Rates of annual ED visits (34% increase), hospitalizations (22% increase) and mean charges (an approximate 30% to 70% increase) from visits involving AORCs increased significantly from 2007 to 2012. Annual rates of ED visits and hospitalizations involving AORCs were lower in urban metropolitan areas compared to other urban/rural designations. AORC-related mortality was highest in small rural communities. Disease profiles revealed that ED visits and hospitalizations involving gout and other crystal arthropathies increased disproportionately compared to other AORCs.

CONCLUSION: The public health burden of AORCs increased significantly over the 6-year period studied, posing a growing challenge for patients, families, and the public health system, and AORCs appear to disproportionately impact nonmetropolitan and other rural communities.