Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 756-761 ◽  
Author(s):  
A P Anandarajah ◽  
M Luc ◽  
C T Ritchlin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Annual Cost ◽  
Financial Analysis ◽  
Financial Burden ◽  
Indirect Costs ◽  
Memorial Hospital ◽  
Systemic Lupus ◽  
Direct And Indirect Costs

Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a financial analysis of all admissions for SLE to Strong Memorial Hospital between 1 July 2013 and 30 June 2015. Patient and financial records for admissions with a SLE diagnosis for the above period were retrieved. The total cost of admissions was used as a measure of direct costs and the length of stay used to assess indirect costs. Additionally, we analyzed the demographics of the hospitalized population. Results The average, annual cost of confirmed admissions to Strong Memorial Hospital for SLE was US$3.9–6.4 m. The mean annual cost per patient for hospitalization was US$51,808.41. The length of stay for all SLE patients was 1564–2507 days with an average of 8.5 days per admission. The majority of patients admitted were young women from the city of Rochester. Infections were the most common reason for admissions. Conclusion We demonstrated that admissions are a source of high direct and indirect costs to the hospital and a significant financial burden to the patient. Implementing measures to improve the quality of care for SLE patients will help decrease the morbidity and lower the economic costs to hospitals.

Hospitalization in patients with systemic lupus erythematosus at Tawam Hospital, United Arab Emirates (UAE): Rates, causes, and factors associated with length of stay

Lupus ◽  
2021 ◽  
pp. 096120332199008
Author(s):  
Reem Aldarmaki ◽  
Hiba I Al Khogali ◽  
Ali M Al Dhanhani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Nephritis ◽  
United Arab Emirates ◽  
Lupus Erythematosus ◽  
Hospitalization Rate ◽  
Systemic Lupus ◽  
Factors Associated ◽  
Icu Admission ◽  
The Mean

Introduction Systemic lupus erythematosus (SLE) is a relapsing and remitting multiorgan disease associated with significant morbidity and mortality. The survival rate of patients with SLE has recently improved, which was associated with increased morbidity and hospitalization rates. Therefore, this study aimed to examine the rate and causes of hospitalization in patients with SLE and explore factors associated with increased length of stay (LOS). Methods Patients who visited rheumatology clinics (Tawam hospital, United Arab Emirates (UAE)) and fulfilled the American College of Rheumatology (ACR) SLE criteria were identified. Retrospective charts were reviewed to determine previous admissions. Demographic data, reason for hospitalization, duration of hospitalization, intensive care unit (ICU) admission, number of specialist consultations, medications used, and SLE characteristics at time of admission were collected. The hospitalization rate was calculated as the number of hospitalized patients divided by the total number of patients with the disease. We performed multivariable regression analysis for factors associated with increased LOS. Results A total of 91 patients with SLE (88 women and 3 men) met the inclusion criteria with a mean disease duration of 10.2 years (SD 5.5). A total of 222 admissions were identified, and 66 of 91 patients were admitted at least once. The mean crude hospitalization rate calculated was 29.8%. The primary reason for admission was pregnancy (29%), SLE activity (24%), and infection (20%). When combining primary and secondary reasons, the proportion of admissions due to SLE activity increased to 32%. The mean LOS was 5.9 (SD 6.0) days. About 7% of admitted patients required ICU admission. In multivariable analysis, patients with lupus nephritis, complications during hospitalization, and increased number of specialists consultations and who were admitted to ICU and started new medication were all associated with increased LOS. Conclusion A significant proportion of patients with SLE were hospitalized during their disease course. The hospitalization rate in this study appears to be higher than those reported elsewhere. Disease flare is the leading cause of admission in patients with SLE in this relatively young cohort. Lupus nephritis has been found to be significantly related to longer LOS. Measurements taken to reduce the incidence and severity of flares would likely decrease hospitalization rate and LOS in patients with SLE.

scholarly journals Pharmacoeconomic analysis of using belimumab for the treatment of systemic lupus erythematosus

2018 ◽  
Vol 11 (3) ◽  
pp. 23-37
Author(s):  
A. G. Tolkushin ◽  
N. L. Pogudina
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Standard Therapy ◽  
Early Stage ◽  
Therapy Group ◽  
Pharmacoeconomic Analysis ◽  
Indirect Costs ◽  
Systemic Lupus ◽  
Standard Therapy Group ◽  
Permanent Disability

The aim is to study the clinical and economic aspects of using belimumab for the treatment of systemic lupus erythematosus (SLe) in patients with high SLe activity, the presence of anti-DNA, a low level of complement in the blood plasma and minimal lupus organ damage at the early stage.Materials and methods. The Markov model of SLe is used. The initial probabilities of the Markov transitions are obtained from analysis of published clinical and observational studies. The prices of the relevant drugs were obtained from the VeD price registry. Medical and nonmedical expenses are calculated on the basis of the current standards for financial costs and coefficients, as well as payments for temporary and permanent disability. Indirect costs are calculated using the method of human capital.Results. It has been found that using belimumab leads to a decrease in costs (both direct and indirect), as well as an increase in patient survival. The total costs for belimumab vs standard therapy approximated 8.84 million rubles vs 17.72 million rubles (of which 4.05 million rubles vs 5.58 million rubles were direct costs, and 2.57 million rubles vs 2.88 million rubles were indirect medical costs) on average per patient in the belimumab group vs standard therapy group, respectively.Conclusion. The use of belimumab in the target population of patients is pharmacoeconomically justified and expedient because it leads to increased treatment efficiency and reduction of direct and indirect costs. 

scholarly journals Rapid and precise diagnosis of pneumonia coinfected by Pneumocystis jirovecii and Aspergillus fumigatus assisted by next-generation sequencing in a patient with systemic lupus erythematosus: a case report

2021 ◽  
Author(s):  
Yili Chen ◽  
Lu Ai ◽  
Yingqun Zhou ◽  
Yating Zhao ◽  
Jianyu Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Next Generation Sequencing ◽  
Aspergillus Fumigatus ◽  
Lupus Erythematosus ◽  
Financial Burden ◽  
Pneumocystis Jirovecii ◽  
Clinical Approach ◽  
Next Generation ◽  
Systemic Lupus ◽  
Generation Sequencing

Abstract Background: Pneumocystis jirovecii and Aspergillus fumigatus, are opportunistic pathogenic fungus that has a major impact on mortality in patients with systemic lupus erythematosus. With the potential to invade multiple organs, early and accurate diagnosis is essential to the survival of SLE patients, establishing an early diagnosis of the infection, especially coinfection by Pneumocystis jirovecii and Aspergillus fumigatus, still remains a great challenge.Case presentation: In this case, we reported that the application of next-generation sequencing in diagnosing Pneumocystis jirovecii and Aspergillus fumigatus coinfection in a Chinese girl with systemic lupus erythematosus (SLE). Voriconazole was used to treat pulmonary aspergillosis, besides sulfamethoxazole and trimethoprim (SMZ-TMP), and caspofungin acetate to treat Pneumocystis jirovecii infection for 6 days. On Day 10 of admission, her chest radiograph displayed obvious absorption of bilateral lung inflammation though the circumstance of repeated fever had not improved. Unfortunately, the patient discharged from the hospital since the financial burden, therefore further condition couldn't be tracked.Conclusions: This successful application of the next generation sequencing assisting the rapid diagnosis of Pneumocystis jirovecii and Aspergillus fumigatus coinfection provides a new perspective in the clinical approach against the systematic fungi infections and highlights the potential of this technique in rapid etiological diagnosis.

scholarly journals The systemic lupus erythematosus Tri-Nation study: Cumulative indirect costs

2007 ◽  
Vol 57 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Pantelis Panopalis ◽  
Michelle Petri ◽  
Susan Manzi ◽  
David A. Isenberg ◽  
Caroline Gordon ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Indirect Costs ◽  
Systemic Lupus

scholarly journals Rapid and Precise Diagnosis of Pneumonia Coinfected by Pneumocystis Jirovecii and Aspergillus Fumigatus Assisted by Next-generation Sequencing in a Patient With Systemic Lupus Erythematosus: a Case Report

2021 ◽  
Author(s):  
Yili Chen ◽  
Lu Ai ◽  
Yingqun Zhou ◽  
Yating Zhao ◽  
Jianyu Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Next Generation Sequencing ◽  
Aspergillus Fumigatus ◽  
Lupus Erythematosus ◽  
Financial Burden ◽  
Pneumocystis Jirovecii ◽  
Clinical Approach ◽  
Next Generation ◽  
Systemic Lupus ◽  
Generation Sequencing

Abstract Background: Pneumocystis jirovecii and Aspergillus fumigatus, are opportunistic pathogenic fungus that has a major impact on mortality in patients with systemic lupus erythematosus. With the potential to invade multiple organs, early and accurate diagnosis is essential to the survival of SLE patients, establishing an early diagnosis of the infection, especially coinfection by Pneumocystis jirovecii and Aspergillus fumigatus, still remains a great challenge.Case presentation: In this case, we reported that the application of next-generation sequencing in diagnosing Pneumocystis jirovecii and Aspergillus fumigatus coinfection in a Chinese girl with systemic lupus erythematosus (SLE). Voriconazole was used to treat pulmonary aspergillosis, besides sulfamethoxazole and trimethoprim (SMZ-TMP), and caspofungin acetate to treat Pneumocystis jirovecii infection for 6 days. On Day 10 of admission, her chest radiograph displayed obvious absorption of bilateral lung inflammation though the circumstance of repeated fever had not improved. Unfortunately, the patient discharged from the hospital since the financial burden, therefore further condition couldn't be tracked.Conclusions: This successful application of the next generation sequencing assisting the rapid diagnosis of Pneumocystis jirovecii and Aspergillus fumigatus coinfection provides a new perspective in the clinical approach against the systematic fungi infections and highlights the potential of this technique in rapid etiological diagnosis.

Hospitalizations in Patients with Systemic Lupus Erythematosus in an Academic Health Science Center

2017 ◽  
Vol 44 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
Kaien Gu ◽  
Dafna D. Gladman ◽  
Jiandong Su ◽  
Murray B. Urowitz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Retrospective Chart Review ◽  
International Classification Of Diseases ◽  
Health Science ◽  
Science Center ◽  
Systemic Lupus ◽  
Short Period ◽  
Classification Of Diseases

Objective.Hospitalization occurs in about 10% of patients with systemic lupus erythematosus (SLE) each year and accounts for most of the direct cost of SLE patient care. We aimed to determine the frequency of admissions of patients with SLE and describe their causes and outcomes.Methods.We identified all hospitalizations at University Health Network in the periods 2011–2012 and 2013–2015 with an International Classification of Diseases, 10th ed. code of M32 (SLE). A retrospective chart review of these patients categorized them based on SLE care provider and cause of admission. Frequency of emergency room visits and duration of hospitalization were ascertained. Poisson and linear regressions were performed to determine factors associated with frequency and duration of hospitalizations.Results.There were 247 unique patients with SLE who were hospitalized a total of 491 times: 87.4% were women, average age of 43.9 ± 17.9 years, and disease duration 13.7 ± 12.3 years. Incidental causes were most common (35.6%); 21.4% and 22.4% of admissions were because of active SLE and infection, respectively. The patients with SLE averaged 1.6 hospitalizations lasting 8.5 days. Thirteen percent of hospitalizations resulted in intensive care unit admission, and 2.8% of hospitalizations resulted in death. Patient employment was associated with fewer hospitalizations during 2011–2015. Antimalarial use was associated with fewer hospitalizations as well as shorter length of stay during 2011–2012. The presence of damage correlated with increased hospitalizations. Higher educational level and antimalarial use correlated with shorter length of stay.Conclusion.Patients with SLE are frequently hospitalized, often because of active SLE or infection, and re-hospitalized within a short period of time.

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