The Burden of Systemic Lupus Erythematosus in Germany: Incidence, Prevalence, and Healthcare Resource Utilization

Objective.Associations between the use of micronutrient supplements (MS) and disease activity, quality of life (QOL), and healthcare resource utilization were studied in a Canadian population of patients with systemic lupus erythematosus (SLE).Methods.QOL was assessed by the Medical Outcomes Study 36-item Short Form. Healthcare resource utilization and disease activity/damage were determined.Results.Of the 259 subjects studied, 53% were MS users and 34% used only calcium/vitamin D. MS users had a higher Systemic Lupus International Collaborating Clinics score and utilized more healthcare resources. Disease activity and QOL were similar between MS users and nonusers.Conclusion.MS are frequently used by patients with SLE and are not associated with concomitant benefit on QOL. MS users utilized more healthcare resources.

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Healthcare resource utilization and costs associated with long-term corticosteroid exposure in patients with systemic lupus erythematosus

Lupus ◽

10.1177/0961203318790675 ◽

2018 ◽

Vol 27 (11) ◽

pp. 1799-1809 ◽

Cited By ~ 6

Author(s):

S Kabadi ◽

J Yeaw ◽

A K Bacani ◽

E Tafesse ◽

K Bos ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Resource Utilization ◽

Lupus Erythematosus ◽

Healthcare Resource ◽

Healthcare Resource Utilization ◽

High Dose ◽

Systemic Lupus ◽

Oral Corticosteroids ◽

Baseline Characteristics ◽

Dose Corticosteroid

Objective To evaluate the association between exposure to oral corticosteroids and future healthcare resource utilization and costs for patients with systemic lupus erythematosus. Methods Adults diagnosed with systemic lupus erythematosus (index date) between 1 January 2008 and 30 June 2013 and naive to oral corticosteroids with continuous health plan enrollment for ≥6 months pre- and ≥5 years post-index were identified from a large health plan claims database. Per-patient monthly average daily dose of oral corticosteroids (prednisone or its equivalent) was calculated for the first 2 years post-index to categorize patients into four steroid exposure cohorts: low (≤5 mg/day), medium (6–20 mg/day), high (>20 mg/day) and no steroids. Differences in healthcare resource utilization and total healthcare costs during the third year post-index across corticosteroid exposure cohorts were modeled with adjustment for baseline characteristics. Results The study included 18,618 systemic lupus erythematosus patients (163 high dose, 1127 medium dose, 6717 low dose and 10,611 no steroids). Compared to low-dose corticosteroid users, high-dose corticosteroid users were more likely to have emergency room visits (39.3% vs. 29.7%; p = 0.0085) and to be hospitalized (21.5% vs. 12.3%; p = 0.0005). After adjustment for baseline characteristics, they also had significantly greater average annual total healthcare costs (US$60,366 vs. US$18,777; p < 0.0001). A 1 mg increase in corticosteroid average daily dose was associated with 1.07 times the average annual costs after adjusting for baseline characteristics ( p < 0.0001). Conclusion Long-term high-dose oral corticosteroid use was associated with significantly greater future healthcare resource utilization and costs. Judicious reduction in daily steroid dose may decrease the imminent economic burden associated with high-dose steroid use in systemic lupus erythematosus.

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Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

BioMed Research International ◽

10.1155/2013/808391 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Hong J. Kan ◽

Xue Song ◽

Barbara H. Johnson ◽

Benno Bechtel ◽

Donna O'Sullivan ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Healthcare Utilization ◽

Resource Utilization ◽

Lupus Erythematosus ◽

Index Date ◽

Healthcare Resource ◽

Healthcare Resource Utilization ◽

Systemic Lupus ◽

Medicaid Population ◽

Annual Total

Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE) in a US Medicaid population were examined.Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x) were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE.Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001). Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754.Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

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Systemic lupus erythematosus in the community. Incidence, prevalence, outcome, and first symptoms; the high prevalence in black women

Archives of Internal Medicine ◽

10.1001/archinte.134.6.1027 ◽

1974 ◽

Vol 134 (6) ◽

pp. 1027-1035 ◽

Cited By ~ 53

Author(s):

W. J. Fessel

Keyword(s):

Systemic Lupus Erythematosus ◽

Black Women ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

High Prevalence ◽

Incidence Prevalence

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Opioid dispensation among systemic lupus erythematosus patients who persistently frequent the emergency department

Journal of Opioid Management ◽

10.5055/jom.2020.0547 ◽

2020 ◽

Vol 16 (1) ◽

pp. 23-31

Author(s):

Jiha Lee, MD, MHS ◽

Lisa Gale Suter, MD ◽

Liana Fraenkel, MD, MPH

Keyword(s):

Systemic Lupus Erythematosus ◽

Emergency Department ◽

Lupus Erythematosus ◽

Opioid Therapy ◽

Healthcare Resource Utilization ◽

Systemic Lupus ◽

Opioid Prescription ◽

Factors Associated ◽

Opioid Administration ◽

Observational Cohort

Objective: To understand prevalence and factors associated with opioid dispensation among systemic lupus erythematosus (SLE) patients who persistently frequent the emergency department (ED) to improve quality of care.Methods: In this retrospective observational cohort study, the authors identified SLE patients who persistently frequented the ED, defined as having three or more ED visits over 12 months, for at least 2 out of 4 years between 2013 and 2016. The authors collected patient-level variables including demographics and long-term opioid therapy (LTOT). Each encounter was categorized as: SLE-, infection-, pain-related, or “other.” Additional encounter-level variables such as healthcare resource utilization and disposition were recorded. The authors used mixed effects multivariate logistic regression to analyze factors associated with (1) opioid administration in the ED and (2) opioid prescription upon discharge from the ED. Results: Seventy-seven SLE patients having 1,143 encounters were identified as persistently frequent ED users. Opioids were administered in the ED for 38 percent of all encounters. Medicaid, LTOT, physician as the ED provider versus advanced-practice providers, more imaging tests, and rheumatology specialty consultation were associated with increased odds of opioid administration in the ED. Opioids were prescribed on discharge for 17 percent of encounters discharged from the ED. African American patients, those on Medicaid, and patients utilizing the ED for SLE-related activity/complications compared to “other” reasons were more likely to receive opioid prescription upon discharge from the ED than their respective counterparts.Conclusion: Opioids are commonly dispensed in the ED for SLE patients. This is true even for patients utilizing the ED for SLE-related disease activity/complications.

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