ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 0144

Healthcare Utilization and Costs Following Kawasaki Disease in Ontario, Canada

Cal Robinson1, Rahul Chanchlani2, Anastasia Gayowsky3, Elizabeth Darling2, Hsien Seow2 and Michelle Batthish2, 1The Hospital for Sick Children, Hamilton, ON, Canada, 2McMaster University, Hamilton, ON, Canada, 3ICES, Hamilton, ON, Canada

Meeting: ACR Convergence 2021

Keywords: Administrative Data, Health Services Research, Vasculitis

  • Tweet
  • Email
  • Print
Session Information

Date: Saturday, November 6, 2021

Session Title: Health Services Research Poster I: Lupus, Inflammatory Arthritis, & More (0128–0148)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: The incidence of Kawasaki Disease (KD) has increased by nearly 50% in Ontario, Canada over the past two decades. Little is known about the long-term burden of illness and healthcare utilization among KD survivors, particularly in a universal healthcare system. The aim of our study was to describe patterns of healthcare utilization and associated costs among KD survivors vs. matched controls in Ontario, Canada.

Methods: We used population-based health administrative databases to identify all children (0-18yr) hospitalized for KD in Ontario between 1995-2018. We excluded non-Ontario residents. Each case was matched to 100 non-exposed comparators by age, sex, and index year and follow-up continued until death or March 2019. Our primary outcomes were hospitalization, emergency department and outpatient visits. We evaluated healthcare costs (in Canadian Dollars [CAD], adjusted for inflation to the 2018 year) associated with each event type, as well as composite healthcare costs, including hospitalizations, ED visits and outpatient costs (i.e., lab services, physician billings and capitation payments).

Results: We compared 4,597 KD survivors to 459,700 matched comparators. Median follow-up duration was 11.1 years (IQR 5.5-17.0) for KD cases and 10.0 years (IQR 4.5-16.0) for non-exposed children. KD survivors had higher rates of hospitalization (adjusted rate ratio 2.07, 95%CI 2.00-2.15), outpatient visits (1.30, 95%CI 1.28-1.33) and ED visits (1.22, 95%CI 1.18-1.26) throughout follow-up (Table 1). Within 1yr post-discharge, 717 (15.6%) of KD cases were re-hospitalized, 4587 (99.8%) had ≥1 outpatient physician visit and 1695 (45.5%) had ≥1 ED visit. KD survivors had higher composite healthcare costs throughout follow-up (median $9,174 vs. $3,148 CAD) (Table 2). Total healthcare costs for KD cases in Ontario were $13.9 million (within one year post-discharge) and $54.8 million (throughout follow-up). Outpatient care was the largest cost driver for both KD (50% of total healthcare costs) and non-exposed cohorts (55%) (Figure 1). However, the proportion of costs attributable to hospitalizations was higher among KD cases (43% vs. 36% non-exposed), due to higher hospitalization costs within the first year post-discharge.

Conclusion: Compared to non-exposed children, KD survivors had significantly higher long-term rates of healthcare utilization and cost. Nearly all KD cases were seen by a pediatrician or primary care physician within one year post-discharge, while less than half were seen by a cardiologist. The rising incidence and attributable costs associated with KD place a significant burden on Ontario’s healthcare system.

Table 1. Healthcare utilization following Kawasaki disease diagnosis

Table 2. Composite healthcare costs following Kawasaki disease diagnosis

Figure 1. Distribution of healthcare costs following Kawasaki disease diagnosis


Disclosures: C. Robinson, None; R. Chanchlani, None; A. Gayowsky, None; E. Darling, None; H. Seow, None; M. Batthish, Abbvie, 5, Novartis, 6, Mylan, 1, Sobi, 1.

To cite this abstract in AMA style:

Robinson C, Chanchlani R, Gayowsky A, Darling E, Seow H, Batthish M. Healthcare Utilization and Costs Following Kawasaki Disease in Ontario, Canada [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/healthcare-utilization-and-costs-following-kawasaki-disease-in-ontario-canada/. Accessed June 3, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/healthcare-utilization-and-costs-following-kawasaki-disease-in-ontario-canada/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences