TBA (17A126)

Trends in hospitalisations for musculoskeletal diseases in Ireland 2005-2015

Author(s)

Bernie McGowan1,6, John J. Carey 2,5, Siobhán O Higgins3 , Edel Doherty4 , Carmel Silke1,5, Bryan Whelan1,5, Miriam O Sullivan1,3 Brian McGuire 3

Department(s)/Institutions

1.The North Western Rheumatology Unit, Our Lady's Hospital, Manorhamilton, Co Leitrim, Ireland. 2. The Dept of Rheumatology, Merlin Park Hospital, Galway 3. The Dept of Psychology, NUIG 4. Discipline of Economics, NUIG 5. Dept of Medicine, NUIG 6. Dept of Pharmacology and Therapeutics, TCD

Introduction

The incidence and prevalence of several musculoskeletal (MSK) diseases are rising rapidly, including osteoarthritis (OA), rheumatoid arthritis (RA) and gout. Hospitalisations are an important metric of health care utilization for any diagnosis, reflecting disease severity, availability of resources, and the infrastructure and policies of the healthcare system.

Aims/Background

This study aimed to analyse hospitalisation trends for MSKs in Ireland over a 11 year period between 2005 and 2015.

Method

Absolute numbers and direct age-standardised rates of hospitalisations for OA, RA and gout in men and women were analysed using the National Hospital In-Patient Enquiry System (HIPE) database between 2005 and 2015. Age bands were further grouped into 3 age categories: ‘young adults’ (Age 19-44 years), ‘middle-aged adults’ (Age 45-69 years) and ‘older adults’ (Age 70 years and older). Future projections of absolute numbers of hospitalisations to 2045 were computed based on the 2015 incidence rates applied to the projected populations.

Results

The age-standardised rates of hospitalisation for OA, RA and Gout increased by 79% with a yearly % increase of 9% (p<.001). Increases in age standardised rates were evident across the three age bands all 3 disease groups. The highest rate of hospitalisations was evident in the over 70 year age group which increased by 38% from 12.2/1000 population to 16.9/1000 population and a significant yearly % increase of 4% (p=0.0004). The number of patient-days per year spent in hospital with a principal diagnoses of OA, RA and Gout decreased from 72,063 days to 53,372 with the largest decrease of 31% in the number of bed days for OA from 62,452 to 43,035. The mean LOS for hospitalisations for the 3 MSDs decreased overall by 43% over the 11-year study period. Assuming stable age-standardised incidence rates from 2014 over the next 30 years, the number of hospitalisations with a principal diagnoses of OA, RA and Gout would be expected to increase by 66 % from 19,924 to 32,999.

Conclusions

The age-standardised rates of hospitalisation for OA, RA and Gout increased by 79% with the highest rate of increase identified in the over 70 year age group which increased from 12.2/1000 population to 16.9/1000 population. The number of hospitalisations with a principal diagnoses of OA, RA and Gout are projected to increase by 66 % from 19,924 to 32,999 by 2045.