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. 2017 Aug 15;12(8):e0182577.
doi: 10.1371/journal.pone.0182577. eCollection 2017.

The burden of septic arthritis on the U.S. inpatient care: A national study

Jasvinder A Singh  1   2   3 , Shaohua Yu  2
Affiliations

The burden of septic arthritis on the U.S. inpatient care: A national study

Jasvinder A Singh et al. PLoS One. .

Abstract

Objective: To assess the health care burden of septic arthritis in the U.S. and examine the associated factors.

Methods: We used the U.S. Nationwide Emergency Department Sample (NEDS) data of patients hospitalized with septic arthritis as the primary diagnosis from 2009-12 to assess time-trends. Multivariable-adjusted models assessed demographics, comorbidity and hospital characteristics as potential predictors of duration of hospitalization, total hospital (inpatient and ED) charges and discharge to home.

Results: In 2009, 2010 and 2012 in the U.S., respectively, there were 13,087, 13,662 and 13,714 hospitalizations with septic arthritis as the primary diagnosis. Respective average hospital stay was 7.4 vs. 7.4 vs. 7.2 days; total hospital charges were $601 vs. $674 vs. $759 million; and proportion discharged home were 43% vs. 43% vs. 44%. Almost 25% each were discharged to a skilled facility or with home health. Age >50 years, Medicaid and self-pay as primary payer, Northeast U.S. hospital location, teaching hospital status, heart failure and diabetes were associated with longer hospitalization; hyperlipidemia, hypertension or gout were associated with a shorter hospital stay. Similar associations were noted for higher hospital charges. Age >50 years, higher income, Medicare insurance, heart failure, diabetes and longer hospital stay were associated with lower odds, and Western U.S. hospital location and gout with higher odds, of discharge to home.

Conclusions: We noted an increase in hospital charges from 2009-12, but no time trends in duration or outcomes of hospitalization for septic arthritis. Comorbidity associations with outcomes indicate the potential for developing interventions to improve outcomes.

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Conflict of interest statement

Competing Interests: There are no financial conflicts related directly to this study. JAS has received research grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta/Horizon and Allergan pharmaceuticals, WebMD, UBM LLC and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA, Inc., a 501 (c)(3) entity. JAS is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee (AMPC); Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. JAS is the editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. SY has no financial conflicts to declare. JAS and SY do not have any non-financial competing interests to declare.

References

    1. Mathews CJ, Weston VC, Jones A, Field M, Coakley G. Bacterial septic arthritis in adults. Lancet. 2010;375(9717):846–55. doi: 10.1016/S0140-6736(09)61595-6 - DOI - PubMed
    1. Mathews CJ, Coakley G. Septic arthritis: current diagnostic and therapeutic algorithm. Curr Opin Rheumatol. 2008;20(4):457–62. doi: 10.1097/BOR.0b013e3283036975 - DOI - PubMed
    1. Freedman J, Guller U, Benjamin DK, Higgins LD, Pan D, Cook C, et al. National trends in health care utilization and racial and socioeconomic disparities in pediatric pyogenic arthritis. J Pediatr Orthop. 2006;26(6):709–15. doi: 10.1097/01.bpo.0000229973.78565.02 - DOI - PubMed
    1. Introduction to the HCUP Nationwide Emergency Department Sample (NEDS), 2009. Healthcare Cost and Utilization Project (HCUP). https://www.hcup-us.ahrq.gov/db/nation/neds/NEDS_Introduction_2009.jsp Rockville, MD: Agency for Healthcare Research and Quality; 2016 [cited 2016 11/27/2016].
    1. Introduction to the HCUP Nationwide Emergency Department Sample (NEDS), 2012. Healthcare Cost and Utilization Project (HCUP). https://www.hcup-us.ahrq.gov/db/nation/neds/NEDS_Introduction_2012.jsp Rockville, MD: Agency for Healthcare Research and Quality; 2016 [cited 2016 11/27/2016].

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