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SLE patients with renal damage incur higher health care costs
Journal article   Open access   Peer reviewed

SLE patients with renal damage incur higher health care costs

A E Clarke, P Panopalis, M Petri, S Manzi, D A Isenberg, C Gordon, J-L Senécal, L Joseph, Y St Pierre and T Li
Rheumatology (Oxford, England), v 47(3), pp 329-333
01 Mar 2008
DOI: https://doi.org/10.1093/rheumatology/kem373
PMID: 18238790
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/rheumatology/kem373View
Published, Version of Record (VoR) Open

Abstract

Adult Bayes Theorem Canada Cohort Studies Combined Modality Therapy Cost of Illness Cost-Benefit Analysis Female Health Care Costs Humans Kidney Function Tests Linear Models Lupus Erythematosus, Systemic - diagnosis Lupus Erythematosus, Systemic - economics Lupus Erythematosus, Systemic - therapy Lupus Nephritis - diagnosis Lupus Nephritis - economics Lupus Nephritis - therapy Male Middle Aged Multicenter Studies as Topic Quality of Life Risk Assessment Severity of Illness Index United Kingdom United States
To compare costs and quality of life (QoL) between SLE patients with and without renal damage. Seven hundred and fifteen patients were surveyed semi-annually over 4 yrs on health care use and productivity loss and annually on QoL. Cumulative direct and indirect costs (2006 Canadian dollars) and QoL (average annual change in SF-36) were compared between patients with and without renal damage [Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC/ACR DI)] using simultaneous regressions. At study conclusion, for patients with the renal subscale of the SLICC/ACR DI = 0 (n = 634), 1 (n = 54), 2 (n = 15) and 3 (n = 12), mean 4-yr cumulative direct costs per patient (95% CI) were $20,337 ($18,815, $21,858), $27,869 ($19,230, $36,509), $51,191 ($23,463, $78,919) and $99,544 ($57,102, $141,987), respectively. In a regression where the renal subscale of the SLICC/ACR DI was a single indicator variable, on average (95% CI), each unit increase in renal damage was associated with a 24% (15%, 33%) increase in direct costs. In a regression where each level in the renal subscale was an indicator variable, patients with end-stage renal disease incurred 103% (65%, 141%) higher direct costs than those without renal damage. Cumulative indirect costs and annual change in the SF-36 summary scores did not differ between patients. SLE patients with renal damage incurred higher direct costs, but did not experience a poorer QoL. QoL may be more influenced by concurrent renal activity than accumulated renal damage, which can occur at any time and patients may gradually habituate to their compromised health state.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Rheumatology
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