Nationwide racial/ethnic disparities in US emergency department visits and hospitalizations for gout.

OBJECTIVES: Gout prevalence is reportedly ∼20% higher in US Black adults than Whites, but racial differences in emergency department (ED) visits and hospitalizations for gout are unknown. We evaluated latest US national utilization datasets according to racial/ethnic groups.

METHODS: Using 2019 US National Emergency Department Sample and National Inpatient Sample databases, we compared racial/ethnic differences in annual population rates of ED visits and hospitalizations for gout (primary discharge diagnosis) per 100,000 US adults (using 2019 age- and sex-specific US census data). We also examined rates of ED visits and hospitalizations for gout among all US ED visits/hospitalizations, and mean costs for each gout encounter.

RESULTS: Compared to White patients, per capita age- and sex-adjusted rate ratio [RR] of gout-primary ED visits for Black patients was 5.01 (95% CI, 4.96, 5.06), for Asian 1.29 (1.26, 1.31), and for Hispanic patients 1.12 (1.10, 1.13). RRs for gout-primary hospitalizations were 4.07 (3.90, 4.24), 1.46 (1.34, 1.58), and 1.06 (0.99, 1.13), respectively. Corresponding ratios among total US ED visits were 3.17 (2.86, 3.50), 3.23 (2.71, 3.85), and 1.43 (1.21, 1.68), and among total US hospitalisations were 2.47 (2.32, 2.64), 3.43 (2.76, 4.72), and 1.21 (1.12, 1.31), respectively. Ratios were largest among Black women. Costs for ED visits and hospitalisations experienced by race/ethnicity showed similar disparities.

CONCLUSION: These first nationwide data found a substantial excess in both gout-primary ED visits and hospitalizations experienced by all underserved racial/ethnic groups, particularly by Black women, revealing an urgent need for improved care to eliminate inequities in gout outcomes.