Health care big data: Gout loves to find middle-aged and elderly male patients. Taking this medicine means that uric acid is not well controlled

“It hurts when the wind blows!”goutIt is an inflammatory disease of the joints. Although it is not fatal, the attack seems to be fatal, and it may even lose the ability to move in severe cases. Gout is more common in middle-aged and male groups. As Taiwan enters a super-aged society, it is a chronic disease that cannot be ignored by the public. Today’s smart doctor ╳Health care big data, in-depth analysis of the gout medical treatment situation of the people, and take you to understand the causes of gout, how to prevent it in advance, and avoid the upper body of the disease.

According to statistics from the National Health Insurance Administration, the number of people diagnosed with gout in 2010 was 950,394, 962,643 in 2019, and 979,803 in 2010. Further analysis of the medical-seeking rate shows that from 2010 to 2011, the rate rose from 4,026.56 to 4,085.71 per 100,000 people to 4,191.61 per 100,000 people. Although the COVID-19 epidemic has affected many people’s willingness to seek medical treatment in the past three years, according to statistics from the National Health Insurance Administration, the number of people with gout who seek medical treatment is still increasing year by year and has not decreased.

On average, 1 in 23 people in Taiwan has gout, and up to 75% of them are men.

Shi Chongliang, director of the National Health Insurance Administration, analyzed that during the COVID-19 epidemic, the whole people strengthened their anti-epidemic measures, greatly reducing the incidence of respiratory diseases, and the number of people seeking medical treatment for respiratory diseases has also decreased. However, gout is a chronic disease, and there is still a certain need for medical treatment. After comprehensive consideration, the National Health Insurance Department will also include the telecare fee in the health insurance payment at the end of 110. Chronic patients can see a doctor at home through video, so that the disease can get good care. Therefore, gout went to the doctor during the epidemic The situation has not diminished.

Nearly 1 million people seek medical treatment for gout every year, and there are about 23 million people in Taiwan, with an average of 1 in every 23 people. Distinguished by gender, up to 75% of gout patients are male. Shi Chongliang said that the number of people with gout is not small. It is worth noting that 70% of gout patients are over 40 years old, especially the 60-year-old group accounts for nearly 24%. It is a chronic disease that should not be ignored by middle-aged people and above, especially men. one.

What are the symptoms of gout?

.acute arthritis

.Swelling and burning pain in the thumb joint (or other joints) of the foot

.Inflammation of multiple joints

.joint stiffness

.joint deformation

.Kidney or soft tissue stones

Most gout patients are treated nearby, and the medical center can handle those with more complicated conditions.

Shi Chongliang pointed out that the cause of gout attacks is related to genetic inheritance and also affected by lifestyle. The major risk factors for gout are hyperuricemia, due to the abnormal metabolism of purin, it leads to long-term accumulation of uric acid, which is difficult to excrete, and uric acid crystals are deposited on the joints to form tophi, acute arthritis, and even urinary tract stones, which may cause joint deformation in the long run. Kidney disease.

Shi Chongliang said that gout patients can significantly reduce gout attacks by adjusting their living habits, such as healthy diet, drinking plenty of water, and proper exercise. Those who have taken stable medication do not stop at will. Most gout patients go to the nearest medical institution for follow-up, such as grass-roots clinics, regional hospitals or regional hospitals. They do not necessarily have to go to the medical center. However, after analyzing the medical data, 7% of the gout patients are diagnosed by the medical center, which may be intractable gout , Complicated disease or other complications derived from it need to be dealt with in a multidisciplinary manner.

40% use colchicine, which means that uric acid is not well controlled and prone to acute attacks.

There are two main categories of gout treatment drugs, including colchicine for acute attacks and drugs for controlling uric acid. According to Shi Chongliang’s analysis, 40% of gout patients use colchicine, which means that people are “prone to acute attacks”, which can be further explained as “uric acid is not well controlled”. He reminded that the uric acid level should not be too high, but no matter how high the uric acid level is, as long as the blood uric acid concentration changes rapidly, such as eating and drinking, strenuous exercise, improper weight loss, etc., it may still cause gout. 

Health insurance has paid for genetic testing to avoid allergies to specific drugs.

One of the uric acid-lowering drugs, Allopurinol, is likely to cause allergic reactions in Asians, which may cause serious adverse drug reactions such as Stephen Johnson’s syndrome (SJS), toxic epidermal lysis (TEN), and systemic peeling. symptom. Shi Chongliang said that in recent years, with the advancement of precision medicine, patients diagnosed with gout can use genetic testing to know whether they are allergic to the drug. The National Health Insurance Administration included it in the health insurance payment last June. 

Symptoms of gout attacks

Seek medical attention early to avoid emergency room visits

The new system of partial burden of health insurance is expected to be launched in two stages this year. The first stage is to adjust emergency and medical expenses, and it will be implemented in April at the earliest, while the partial burden of inspections and inspections is still to be discussed. Shi Chongliang said that part of the burden and medical expenditure “basically increase and decrease at the same time.” Pushing part of the burden mainly encourages the public to seek medical treatment correctly and curb waste. He also hopes that doctors will assist patients in front-end prevention, including regular health education and drug review. It is the responsibility to control disease and maintain health, and the role of health insurance should be the “last safety net”.

As far as gout is concerned, Shi Chongliang said that although gout patients mostly attack in the middle of the night, the affected parts are mainly toes, fingers and other joints, and sometimes the pain is so painful that they have to go to the emergency room, but in fact, most of them have symptoms before gout attacks. Be vigilant and go to the clinic for medical treatment. In addition to implementing partial burdens, the National Health Insurance Administration also promotes integrated care plans for family physicians. Family physicians regularly provide health education advice for gout patients, combined with lifestyle habits and correct diet concepts, to help gout patients control their diseases.

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