Cost of treatment of childhood-onset systemic lupus erythematosus
Cost of treatment of childhood-onset systemic lupus erythematosus
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DOI：
10.1002/art.21845
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发表时间：
2006-04-15
期刊：
影响因子：
--
通讯作者：
Klein-Gitelman, MS
中科院分区：
文献类型：
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作者：
Brunner, HI;Sherrard, TM;Klein-Gitelman, MS
客观的。确定儿童期发病的系统性红斑狼疮 (cSLE) 儿童的直接护理费用，并使用 cSLE 确定每个质量调整生命年 (QALY) 的直接费用。方法。对美国 2 个大型三级儿科风湿病中心的管理数据库进行了审查，了解 2001 年 1 月至 2004 年 4 月期间在这些中心诊断并定期接受治疗的所有 cSLE 患者 (n = 119)。文献中报道的 cSLE 患者 (n = 297) 的健康相关生活质量估计用于根据儿童健康问卷的全球健康评级（范围0-100).结果。分析中纳入了 3,184 个患者月的随访信息。在平均 27 +/- 11.8 个月的 SD 随访期间，该队列的直接护理费用达 3,965,048 美元，不包括门诊药物。无论患者性别如何，每月 cSLE 的平均 SD 费用为 1,245 +/- 2,352 美元，或每年 14,944 美元。住院和日间医院护理费用占28%，实验室检查占21%，住院/日间病人药物费用占13%，透析占11%。风湿病诊所就诊次数仅占直接护理费用的 9%。当包括估计的门诊药物费用 1,190 美元时，每个 QALY 的 cSLE 直接费用为 30,908 美元。结论。研究发现，诊断患有 cSLE 的儿童需要承担相当大的直接护理费用。 cSLE 的治疗似乎比文献报道的成人 SLE 和幼年特发性关节炎的治疗费用要高得多。
Objective. To determine the direct cost of care of children with childhood-onset systemic lupus erythematosus (cSLE), and to determine the direct cost per quality-adjusted life year (QALY) with cSLE.Methods. Administrative databases from 2 large tertiary pediatric rheumatology centers in the United States were reviewed for all patients with cSLE (n = 119) diagnosed and regularly treated in these centers between January 2001 and April 2004. Health-related quality of life estimates for patients with cSLE (n = 297) reported in the literature were used to calculate QALYs based on global health ratings of the Child Health Questionnaire (range 0-100).Results. Information on 3,184 patient-months of followup was included in the analysis. During a mean SD followup of 27 +/- 11.8 months, the direct cost of care for the cohort amounted to $3,965,048, excluding outpatient medications. Irrespective of patient sex, the mean SD cost of cSLE per month was $1,245 +/- $2,352, or similar to$14,944 per year. Inpatient and day hospital care accounted for 28% of the cost, laboratory testing accounted for 21%, inpatient/day-patient medication costs accounted for 13%, and dialysis accounted for 11%. Visits to the rheumatology clinic only contributed 9% to the direct cost of care. When including an estimated outpatient medication cost of $1,190, the direct cost of cSLE per QALY was $30,908.Conclusion. Children diagnosed with cSLE were found to have a considerable direct cost of care. The treatment of cSLE appears to be far more costly than that of adult SLE and juvenile idiopathic arthritis reported in the literature.