Hospitalisation and the treatment of rheumatoid arthritis

People with rheumatoid arthritis may receive hospital care when their symptoms are not manageable through primary health care interventions. Hospitalisations for rheumatoid arthritis involve interventions to restore functional capacity, and relieve pain.

Data from the AIHW National Hospital Morbidity Database (NHMD) show that, in 2014–15:

  • there were 11,982 hospitalisations with the principal diagnosis of rheumatoid arthritis
  • the hospitalisation rate for females (76 per 100,000 population) was 3 times that of males (25 per 100,000)
  • the hospitalisation rate increased with age until the age of 70–74 (Figure 1).

Figure 1: Rate of hospitalisation for rheumatoid arthritis, by sex and age, 2014–15

The vertical bar chart shows that in 2014–15, the hospitalisation rate for the principal diagnosis of rheumatoid arthritis was 3 times higher for females than males. The hospitalisation rate increased with age until the age of 70–74.

Source: AIHW National Hospital Morbidity Database (Data table).

From 2005–06 to 2014–15, age standardised hospitalisation rates for rheumatoid arthritis increased from 29 per 100,000 to 46 per 100,000 (Figure 2). Over the period, the age standardised hospitalisation rate for females was more than twice that of males.

Figure 2: Rate of hospitalisation for rheumatoid arthritis, by sex, 2005–06 to 2014–15

The line chart shows that between 2005–06 and 2014–15, there was a rise of over 200%25 for administering drug treatments (administration of pharmacotherapy) for people hospitalised for rheumatoid arthritis. In comparison, rates for other common procedures for rheumatoid arthritis decreased (-8%25 for administration of blood and blood products; –2%25 for allied health interventions and –12%25 for knee replacement).

Note: Rates are age-standardised to the Australian population as at 30 June 2001.

Source: AIHW National Hospital Morbidity Database (Data table).

Between 2005–06 and 2014–15, there was a rise of over 200% for administering drug treatments (administration of pharmacotherapy) for people hospitalised for rheumatoid arthritis. In comparison, rates for other common procedures for rheumatoid arthritis decreased (–8% for administration of blood and blood products and –2% for allied health interventions and –12% for knee replacement).

Figure 3: Number of selected procedures for rheumatoid arthritis, 2005–06 to 2014–15

The line chart shows that between 2005–06 and 2014–15, there was a rise of over 200%25 for administering drug treatments (administration of pharmacotherapy) for people hospitalised for rheumatoid arthritis. In comparison, rates for other common procedures for rheumatoid arthritis decreased (-8%25 for administration of blood and blood products; –2%25 for allied health interventions and –12%25 for knee replacement).

Source: AIHW National Hospital Morbidity Database (Data table).

In 2014–15, a total of 19,037 procedures and other interventions were provided for people with the principal diagnosis of rheumatoid arthritis. There were more procedures than hospitalisations for rheumatoid arthritis as one person may have more than one procedure performed during their hospital stay, e.g. knee replacement and anaesthetic. Most of the procedures (49%) were for administering drug treatments, followed by allied health interventions such as physiotherapy, occupational therapy or dietetics (17%).

It should be noted that the allied health interventions are only those provided whilst the person was an admitted patient in a hospital. Allied health interventions are frequently recommended for people with rheumatoid arthritis and can be provided as outpatient services or in the primary health care setting [1], which are not captured in these hospital morbidity data.

Table 1: Common procedures performed in hospitalisations for rheumatoid arthritis, 2014–15

Procedure Number Per cent(a)
Administration of pharmacotherapy 9,260 49
Allied health interventions 3,230 17
Knee replacement 319 2
Administration of blood and blood products 311 2
Other 5,917 31
Total 19,037 100
  1. Per cent of total procedures for hospitalisations for rheumatoid arthritis.

Notes

  1. The Australian Classification of Health Interventions (ACHI) codes 8th edition [2] were used to record hospital procedures for patients admitted to hospital with a principal diagnosis of rheumatoid arthritis in 2014–15.

  2. The ACHI codes for pharmacotherapy were those which came under the block number 1920; for allied health interventions were those that came under the block number 1916; for administration of blood and blood products were those that came under block number 1893; and for knee replacement block numbers 1518 and 1519.

  3. 'Other' includes those procedures which individually amount to less than 2% of all procedures for rheumatoid arthritis

Source: AIHW National Hospital Morbidity Database.

References

  1. Raven M, Brown L, Bywood P. (2014). Allied health integration: Collaborative care for arthritis and other musculoskeletal conditions. PHCRIS Policy Issue Review. Adelaide: Primary Health Care Research & Information Service.
  2. NCCC (National Casemix and Classification Centre) 2012. The international statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM), Australian Classification of Health Interventions (ACHI) and Australian Coding Standards (ACS), 8th edn. Wollongong: University of Wollongong.