• WongPeter K KPKK0000-0002-2182-1815Department of Rheumatology, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia.Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney,, Beverly C K Ng, James Mitchell, Joanne Han, Cinda Lam, David Spencer, Ken Cai, and Nicholas Manolios.
• Department of Rheumatology, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia.
• Intern Med J. 2023 Aug 1; 53 (8): 145014571450-1457.

BackgroundGout is a common chronic inflammatory disorder due to monosodium urate deposition, which results in severe inflammatory arthritis. It is particularly common in those of Māori or Pacific Islander heritage. There is a significant number of this at-risk ethnic group in western Sydney.AimsTo determine the healthcare burden of gout in Western Sydney.MethodsWe characterised patients managed in the emergency departments (EDs) of the four Western Sydney Local Health District (WSLHD) hospitals and those admitted for gout as the primary or secondary diagnosis from 1 January 2017 to 31 December 2018.ResultsThere were 472 patients managed in ED on 552 occasions at a direct cost to the LHD of A$367 835. Those of Māori or Pacific Islander ethnicity comprised 25.2% (n = 119/472), while half (n = 39/80) of those managed in ED for gout on two or more occasions were of Māori or Pacific Islander ethnicity. Overall, 310 patients were admitted with gout as the principal diagnosis on 413 occasions at a cost of A$1.73 million. Seventy-five (24.2%) of the 310 patients were of Māori or Pacific Islander heritage. A total of 584 WSLHD inpatients had gout as a secondary diagnosis. This was associated with 714 admissions.ConclusionsThe disproportionately large healthcare burden of gout in Western Sydney from the relatively small Māori and Pacific Islander population needs attention. Urgent culturally appropriate interventions to address gout are required to address this inequality.© 2022 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.

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