Adrenal Insufficiency: Investigating Prevalence and Healthcare Utilization Using Administrative Data

Sarpreet S. Sekhon; Katelynn Crick; Tyler W. Myroniuk; Kevin S. C. Hamming; Mahua Ghosh; Denise Campbell-Scherer; Roseanne O. Yeung

Disclosures

J Endo Soc. 2022;6(4) 

In This Article

Results

Period Prevalence of AI

Over the 5-year period, 2637 patients were recorded to have made an outpatient or ED visit related to AI. Using the defined case definition (Table 1), the estimated prevalence of AI was 0.0839%, or 839 per million persons, in Alberta between 2014 and 2018.

Healthcare Utilization

Number of Visits Made by Patients With AI. Patients with AI made a total of 211 207 emergency and outpatient visits for any reason. Out of these visits, 5.7% (n = 12 060) were recorded as being related to the treatment of AI. Table 2 illustrates the frequency of outpatient and emergency healthcare utilization visits made by patients with AI and for the subset of visits made by these patients with a code for AI. Of the visits for any reason, 98.6% (n = 208 199) were outpatient visits. Of the 12 060 visits related to AI, 87.9% (n = 10 596) were outpatient visits.

Visit Rates. Figures 1 and 2 display the rate of emergency and outpatient visits per patient over time with arrows indicating the percentage change in visit rates between each year. Patients with AI made an average of 2.26 (SD = 0.13) and 17.82 (SD = 4.40) visits per patient per year for the treatment of any reason in the emergency and outpatient settings, respectively.

Figure 1.

Emergency and outpatient visit rates for any reason by patients with AI.

Figure 2.

Emergency and outpatient visit rates for the treatment of AI.

Outpatient Visits for any Reason: The line of best fit for outpatient visits in Figure 1 depicts that outpatient visits per patient per year for any reason have been generally increasing over time among this patient population (P < 0.01). The rate of increase has been slowing over time, as indicated by the arrows in Figure 1.

Emergency Visits for any Reason: The line of best fit for emergency room visits in Figure 1 depicts that emergency visits per patient per year for any reason have remained relatively stable over time (P = 0.59). On average, there was an increase of 0.03 emergency room visits per patient each year over the time period.

Visits Coded for the Treatment of AI: Patients with AI made an average of 0.13 (SD = 0.01) and 0.91 (SD = 0.07) visits per patient per year for the treatment of AI in the ED and outpatient settings, respectively.

Outpatient Visits for the Treatment of AI: As shown in Figure 2, the overall trend in outpatient visits per patient per year related to the treatment of AI is that these visits have been increasing over time (P < 0.05). The magnitude of the increase in visits per patient per year, however, was small (increasing by 0.04 visits per patient per year, on average).

Emergency Visits for the Treatment of AI: As shown in Figure 2, there have been small fluctuations in the number of emergency room visits per patient over time. The overall trend, however, has remained relatively stable (P = 0.62).

Top 10 Reasons for Visiting the ED: There were 2699 different main reasons for visiting the ED. Table 3 illustrates the top 10 reasons patients with AI visited the ED over this time period.

Top 10 Main Reasons for Outpatient Visits: There were 4821 different main reasons for outpatient visits. Table 4 illustrates the top 10 main reasons patients with AI visited an outpatient clinic over the time period.

Medications

Most patients with AI were dispensed only glucocorticoid medications over the time period (71.6%, n = 1889). Nearly one third (27.4%, n = 722) of patients with AI were dispensed both glucocorticoid and mineralocorticoid medications, and a small proportion (1.0%, n = 26) were dispensed only mineralocorticoids over the time period.

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