Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

Hong J Kan,Benno Bechtel,Donna O'Sullivan,Barbara H Johnson,Charles T Molta,Xue Song

doi:10.1155/2013/808391

Abstract

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.

Highlights

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variety of clinical manifestations and autoantibodies [1]
Multivariate regressions were conducted to estimate the marginal impact of having SLE on healthcare utilization and costs, controlling patients’ demographic and clinical characteristics between matched SLE and non-SLE patients
Generalized linear models (GLMs) models estimated that SLE patients had $10,984 more total cost, $5,890 more inpatient costs, $2,418 more outpatient costs, and $1,160 more outpatient pharmacy

Summary

Introduction

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variety of clinical manifestations and autoantibodies [1]. It is estimated that 161,000 to 322,000 people in the US have been diagnosed with SLE [2, 3]. In the US, minority populations, especially African Americans and Hispanics and people of lower socioeconomic status, have a higher overall prevalence of SLE [5]. A study of a commercial population estimated a mean annual medical cost of $12,238 higher (2005 dollars) in SLE patients than matched non-SLE patients [7]. Neither study examined SLE ares nor the costs associated with ares. Neither study examined SLE ares nor the costs associated with ares. is study used more recent administrative claims data to estimate healthcare utilization and costs associated with SLE and examined cost of ares in a prevalent SLE population in Medicaid

Methods

Results

Discussion

Conclusion