Long-Term Medical Costs and Resource Utilization in Systemic Lupus Erythematosus and Lupus Nephritis: A Five-Year Analysis of a Large Medicaid Population
Long-Term Medical Costs and Resource Utilization in Systemic Lupus Erythematosus and Lupus Nephritis: A Five-Year Analysis of a Large Medicaid Population
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DOI：
10.1002/art.24545
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发表时间：
2009-06-15
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影响因子：
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通讯作者：
Goetzel, Ron Z.
中科院分区：
文献类型：
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作者：
Li, Tracy;Carls, Ginger Smith;Goetzel, Ron Z.
客观的。评估系统性红斑狼疮 (SLE) 患者和部分 SLE 肾炎患者的长期直接医疗费用和医疗保健利用率。方法。 MarketScan 医疗补助数据库（1999-2005 年）中发现了新出现的 SLE 患者，其中包括超过 1000 万医疗补助受益人的所有住院患者、门诊患者、急诊科和药品索赔。患者重新开始活动的日期被定义为最早观察到的 SLE 诊断代码，诊断前有 6 个月的清洁期。该方法对 2,298 名患者进行了连续 5 年的随访。使用倾向评分匹配构建了无 SLE 患者的参考组。根据涉及肾脏的诊断和程序代码评估肾炎。结果。 SLE 患者第一年的平均年度医疗费用总计为 16,089 美元，明显高于参考患者（高出 6,831 美元）。成本在第 2 年略有下降，但到第 5 年以平均 16% 的速度逐年增加，达到 23,860 美元。无肾炎的 SLE 患者 (n = 1,809) 的费用比参考患者高 967-3,756 美元。患有肾炎的 SLE 患者 (n = 489) 的费用比参考组高出 13,228-34,907 美元。肾炎亚组的人均住院就诊次数为 0.6-1.0 次，大约是所有 SLE 患者的两倍，是参考组的 3 至 4 倍。结论。 SLE 是一种治疗费用昂贵的疾病。随着时间的推移，系统性红斑狼疮患者的医疗费用稳步增加，尤其是肾炎患者。
Objective. To estimate the long-term direct medical costs and health care utilization for patients with systemic lupus erythematosus (SLE) and a subset of SLE patients with nephritis.Methods. Patients with newly active SLE were found in the MarketScan Medicaid Database (1999-2005), which includes all inpatient, outpatient, emergency department, and pharmaceutical claims for more than 10 million Medicaid beneficiaries. The date a patient became newly active was defined as the earliest observed SLE diagnosis code, with a 6-month clean period prior to the diagnosis. This method identified 2,298 patients with a consecutive followup of 5 years. A reference group of patients without SLE was constructed using propensity score matching. Nephritis was assessed based on diagnosis and procedure codes involving the kidney.Results. Mean annual medical costs for SLE patients totaled $16,089 at year 1, which is significantly greater (by $6,831) than that for reference patients. Costs decreased slightly at year 2 but then increased yearly at an average rate of 16% through year 5, to $23,860. SLE patients without nephritis (n = 1,809) had costs $967-3,756 higher than the reference patients. SLE patients with nephritis (n = 489) had costs $13,228-34,907 greater than the reference group. Inpatient visits for the nephritis subgroup were 0.6-1.0 per capita, which are approximately twice the rate for all SLE patients and 3 to 4 times higher than the reference group.Conclusion. SLE is a costly condition to treat. Medical expenses incurred by SLE patients increase steadily over time, particularly for patients with nephritis.