Gouty Arthritis Patients’ Health Economic Disease Burden and Healthcare Resource Consumption

Abstract

Objective: To investigate the health economic burden of disease and healthcare resource utilization among patients with gouty arthritis. Methods: Medical records of patients with gouty arthritis documented in the Langchao database from January 1, 2020, to December 31, 2024, were selected. Descriptive analysis and statistical tests were conducted on healthcare resource consumption, types of medications used, and corresponding recurrence and new-onset disease events during patients’ visits. For between-group comparisons of normally distributed continuous variables, t-tests or analysis of variance (ANOVA) were employed; for non-normally distributed continuous variables, Wilcoxon rank-sum tests or Kruskal-Wallis H tests were used; for categorical variables, Pearson’s χ² tests or Fisher’s exact tests were applied. Results: This study included 96,199 patients with gouty arthritis, with a mean age of 50.49 years, of whom 68.65% were male. Patients used nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and glucocorticoids a total of 1,089,800 times, with NSAIDs accounting for 57.32%, colchicine for 1.38%, and glucocorticoids for 41.30%. From 2020 to 2024, patients had 4,440,466 outpatient visits (annual average of 12.65 visits) and 85,078 hospitalizations (annual average of 0.55 admissions). Hospitalized patients had an average length of stay of 8.73 days per admission, with an average of 10.27 laboratory tests and 1.74 examinations per hospitalization, substantially higher than for outpatients. In terms of expenditures for patients with gouty arthritis, hospitalized patients incurred higher laboratory test costs (253.26 yuan/person/year) and examination costs (472.53 yuan/person/year) compared to outpatients (laboratory tests: 137.00 yuan/person/year; examinations: 257.47 yuan/person/year), suggesting greater disease complexity and resource consumption. In the one-year follow-up after acute gout flares, recurrence rates differed across the three medication groups: the glucocorticoid group had an average of 3.28 recurrences, the colchicine group 2.82, and the NSAIDs group the lowest at 2.21. For new-onset adverse events, no significant differences were observed among the groups in gastrointestinal ulcers (P = 0.236) or bleeding (P = 0.069). However, significant differences existed in hepatic dysfunction (P = 0.033), renal impairment (P < 0.001), and cardiovascular/cerebrovascular events (P < 0.001). The glucocorticoid group exhibited the highest rates, with 2.72% for hepatic dysfunction, 5.90% for renal impairment, and 18.45% for cardiovascular/cerebrovascular events. Conclusion: Based on real-world electronic medical record data from the Langchao database (2020–2024), this study systematically evaluated the health economic burden and healthcare resource utilization of patients with gouty arthritis. The findings indicate a generally high level of healthcare resource consumption in real-world settings, particularly the substantial burden from laboratory tests and examinations among inpatients. Hospitalized patients incurred higher laboratory and examination costs than outpatients, suggesting greater disease severity, higher diagnostic and therapeutic complexity, and increased resource consumption. Regarding medication use, NSAIDs were the most frequently used agents and were associated with lower recurrence rates, although their potential adverse effects on renal function and cardiovascular risk warrant attention. The glucocorticoid group showed the highest recurrence rates and adverse event incidence, indicating that these agents should be used cautiously, particularly in patients with hepatic or renal dysfunction or elevated cardiovascular risk. Individualized medication management and monitoring should be strengthened to reduce recurrence frequency and adverse events, thereby alleviating disease burden and optimizing healthcare resource utilization. Clinicians are advised to comprehensively consider drug efficacy, recurrence risk, adverse events, and resource consumption when developing individualized treatment plans to achieve cost-effectiveness optimization and provide a scientific basis for healthcare policy formulation.