Trajectory of Healthcare Resources Utilization in Giant Cell Arteritis - A Population-Based Study.

2021 
Objective To estimate the healthcare resource utilization (HRU) in patients with giant cell arteritis (GCA) compared with the general population in southern Sweden. Methods The study sample comprised 653 GCA patients along with ten age-, sex-, and residency-area-matched reference subjects per patient. Data on public and private healthcare consultations and hospitalizations were extracted from the Skane Healthcare Register. We assessed trajectories of primary and specialist healthcare visit, as well as hospital admissions, and inpatient days from three years before through five years after the date of GCA diagnosis for patients and matched references. HRU was analysed using generalized estimating equations adjusted for sex, age at the index year, calendar year of diagnosis, education, income, marital status, place of birth, and Charlson comorbidity index. Inverse probability weighting was used to account for drop-out during study. Results GCA patients had higher rate of healthcare visits than the references from the year before GCA diagnosis up to four years after diagnosis with the largest relative (rate ratio [95% CI]: 1.85 [1.68, 2.05]) and absolute (mean difference [95% CI]: 10.2 [8.1, 12.3] visits per-person) differences in the year of diagnosis. Similar trajectories were observed for primary and specialist healthcare visits. For hospital admissions and inpatient days, the differences disappeared one year after diagnosis date. Conclusion Patients with GCA utilized health care services at a significantly higher rate than a reference population. The increased utilization among Swedish patients with GCA was evident one year before and prolonged up to four years after diagnosis date.
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