CLinical Prediction Rule Score in Veterans

• Health utility index, SF-6D [ Time Frame: 18-months ] [ Designated as safety issue: No ]
  at 18-month post-survey
• Health care utilization [ Time Frame: 1-year post-survey ] [ Designated as safety issue: No ]
  Health care utilization as sum of outpatient, inpatient and emergent care utilization
• Activity limitation on Katz 6 ADL [ Time Frame: 18-months ] [ Designated as safety issue: No ]
  Katz 6 ADL questions assess difficulty with doing 6 key activities, bathing, eating, toileting, walking, getting up and climbing stairs
• Mortality [ Time Frame: 5-years ] [ Designated as safety issue: No ]
  Up to 5-year post-survey

• Health utility index [ Time Frame: 18-months ] [ Designated as safety issue: No ]
  Health-related quality of life was assessed from the cross-sectional Sf-36 for veterans (SF-36V) survey which was performed for the cohort who had 1 or more VA visit in the 18-months prior to the survey. We will calculate the Health utility index by calculating SF-6D from the SF-36 subscale scores.
• Health care utilization [ Time Frame: 1-year post-survey ] [ Designated as safety issue: No ]
  Health care utilizationa as sum of outpatient, inpatient and emergent care utilization

We will study whether the health care costs and health utilities differ in patients with gout and those without gout and whether they differ between those with more severe versus less severe gout

The purpose of this project is to study the out-patient and inpatient utilization and costs associated with tophaceous gout (a classic form of treatment-failure gout), compare these costs to patients with non-tophaceous gout and evaluate health utilities associated with these gout states. The analyses will be conducted in a manner to support a burden of illness type of presentation / manuscript.

Study Questions

1. What are the VA health care costs (inpatient and outpatient) for patients with gout compared to those without gout?
2. Does health utility, as calculated by SF-6D, differ in patients with gout compared to patients without gout and between tophaceous and non-tophaceous gout?
3. What are the relationships between costs and health utility?
4. How does the burden of illness differ by subgroups of gout patients (costs and utilities)?
5. What are the VA health care costs for patients with tophaceous gout and are they higher than patients with non-tophaceous gout?

Inclusion criteria Patients with and without gout from the Veterans database described above will be included in the analyses for Study aims 1 and 5. This is approximately 3000 gout patients and 67,000 non-gout patients

Patients with SF-36 data from the above cohort will be included in the analyses for Study aims 2-4. This is approximately 1500 gout patients and 38,000 non-gout patients

Patients with and without gout from the Veterans Upper Midwest SF-36 survey database will be included in the analyses for Study questions 1 and 5. This is approximately 3000 gout patients and 67,000 non-gout patients Patients with SF-36 data from the above cohort will be included in the analyses for Study aims 2-4. This is approximately 1500 gout patients and 38,000 non-gout patients

• Gout
  Patients with ICD-9 for gout
• No Gout
  Patients withOUT ICD-9 for gout
• Tophaceous gout
  Patients with ICD-9 for tophaceous gout
• non-tophaceous gout
  those with ICD-9 for gout other than the codes specific for tophaceous gout

Inclusion Criteria:

• participated in the survey
• Have SF-36 adn utilization data

Exclusion Criteria:

• Absence of utilization and/or cost data

• Department of Veterans Affairs
• Takeda Global Research & Development Center, Inc.
• Novartis
• Regeneron Pharmaceuticals