Utility of the Suficiencia database in Colombia: an application to healthcare costs of rheumatoid arthritis and systemic lupus erythematosus

Abstract

Suficiencia is a large database that encompasses information of 15.1 million enrollees at ten health maintenance organizations (HMOs) on each healthcare service provided to patients, being the main source of information for estimating cost at the individual level. It constitutes a reliable tool for measuring prevalence and costs of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in Colombia, where these data are scarce. The aim of this study is to describe and show the utility of the Suficiencia database for studies on RA and SLE in Colombia. To estimate the RA and SLE cost, patients were identified according to ICD-10 codes in the Suficiencia dataset for year 2015. We calculated the number of RA/SLE patients and their individual cost as the sum of all claims in each type of facility (i.e., inpatient, outpatient, emergency, domiciliary). We then estimated the total cost of care and average cost per patient. We also report RA and SLE prevalence. The estimates of prevalence of RA and SLE were 737/100,000 and 117/100,000 respectively. Results show that the annual average healthcare cost of a person with RA is $1625, while the cost for a person with SLE is $1693. Women were more affected by these conditions, but men's care was more expensive. The cost of RA and SLE care in the developing world may be relatively high. Total cost represents about 4% of total healthcare expenses in Colombia.