WEST HAVEN, CT — Would addressing comorbidities in multiple sclerosis patients help reduce use of all-cause emergency services?
A new study in Multiple Sclerosis and Related Disorders pointed out that MS patients tend to have greater healthcare usage, including emergency department visits.1
Authors from the VA Connecticut Healthcare System and Trinity Health of New England found that the risk of having at least one ED visit were 20% higher with each comorbidity, and that veterans with certain comorbidities were more likely to seek emergency care.
“While comorbidities have been associated with all-cause hospitalizations among persons with multiple sclerosis (MS), there has been no examination of their role in all-cause emergency department (ED) utilization,” the researchers noted. “As such, this study aimed to determine if the presence of comorbidities increases the odds of ED usage in a national sample of Veterans with MS.”
To do that, the study team extracted data retrospectively from the VA MS Center of Excellence Data Repository, an electronic health record-based dataset. Included in the database were 3,742 veterans who had at least one outpatient visit in 2013 and were alive in 2015 and were initially prescribed a disease modifying therapy.
CPT codes were used to determine if participants had at least one ED visit during a 24-month time frame beginning on Jan. 1, 2013, while ICD-9 codes present before 2013 were used to track comorbidities.
Results indicated that almost 32% (n = 1,191) had at least one ED visit and that the veterans with an ED visit had an average of 6.67 (SD=3.32) comorbidities. “After adjusting for demographics, the number of comorbidities was a significant predictor of ED usage (aOR=1.20; 95% CI: 1.17, 1.23, p<0.001),” the authors wrote. “Several comorbidities emerged as independent contributors.”
Researchers concluded that all-cause ED utilization “is prevalent in MS, with usage increasing in the presence of other chronic conditions. These findings underscore the need to view long-term MS care through the lens of chronic disease management.”
- Gromisch ES, Turner AP, Leipertz SL, Neto LO, Beauvais J, Haselkorn JK. Comorbidities as predictors of all-cause emergency department utilization among veterans with multiple sclerosis. Mult Scler Relat Disord. 2022 Jun;62:103806. doi: 10.1016/j.msard.2022.103806. Epub 2022 Apr 15. PMID: 35452963.