The Problem with Gout Is That It’s Still Such a Problem

> The problem at this point is that there is a problem. > > — Captain Obvious Gout is a problem. It’s a big problem for patients, for caregivers and employers, and for healthcare systems characterized by dwindling resources, and it’s a burgeoning problem for society at large. By far the most common form of inflammatory arthritis, gout affects about 4% of US adults1 and leads to substantial healthcare use among affected patients2. Gout’s footprint is all the more relevant with its resulting morbidity, loss of productivity, and accelerated mortality experienced by its patients3,4. Two separate reports appearing in the current issue of The Journal examine emergency department (ED) use in gout care and serve to further highlight the burden of this ancient disease5,6. Both these studies examine ED use in gout care using the National Emergency Department Sample (NEDS), an element of the Healthcare Cost and Utilization Project sponsored by the US Agency for Healthcare Research and Quality7. Highly generalizable and publically available, NEDS captures and characterizes 20% of such visits occurring annually across the United States, and allows for national estimates of ED visits. Using NEDS data from 2006 through 2008, our group estimated that there were more than 170,000 ED visits for gout as a primary diagnosis in 2008 alone, accounting for ∼0.2% of all ED visits nationally and generating corresponding total charges of more than $160 million in a single year2. Extending this observation period, Jinno and colleagues note that between 2006 and 2012, ED visits for gout increased significantly by 14% overall, with an even greater increase observed for patients between 45 and 54 years of age5. Moreover, the authors note that resulting healthcare charges grew at an even higher rate, nearly doubling from … Address correspondence to Dr. T.R. Mikuls, University of Nebraska Medical Center, Division of Rheumatology, 983025 Nebraska Medical Center, Omaha, Nebraska 68198, USA; E-mail: tmikuls{at}unmc.edu

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