Abstract：
BACKGROUND: Infections are considered risk factors for autoimmune inflammatory rheumatic diseases (AIRDs), the incidence of which is considered to have been impacted by the COVID-19 pandemic. The impact of non-pharmaceutical interventions (NPIs) on the incidence of AIRDs and their associated health care services and medical expenses in Korea was investigated.
METHODS: We included all AIRD cases reported between January 2016 and February 2021 based on the National Health Insurance Service data. We evaluated changes in incidence trends for each AIRD before and after NPI implementation (Feb 2020 to Feb 2021) using segmented regression analysis. Changes in health care utilization and medical costs for each AIRD before and after NPI implementation were also investigated.
RESULTS: After NPI implementation, monthly incidence rates declined significantly by 0.205 per 1 000 000 (95% confidence interval [CI], -0.308 to -0.101, p < .001) in patients with systemic lupus erythematosus (SLE). No significant changes in the incidence of all AIRDs other than SLE were observed before and after implementation. Further, annual outpatient department visits per patient were lower during implementation for all diseases, except juvenile idiopathic arthritis (JIA). The prescription days per outpatient visit increased significantly during implementation for all diseases, except JIA and ankylosing spondylitis. During implementation, the total annual medical costs per patient tended to decrease for all diseases, except JIA and mixed connective tissue disease.
CONCLUSIONS: Implementation of NPIs to contain the pandemic led to a reduction in the incidence of SLE and changed patterns of medical care utilization and treatment cost for most AIRDs.
METHODS: We included all AIRD cases reported between January 2016 and February 2021 based on the National Health Insurance Service data. We evaluated changes in incidence trends for each AIRD before and after NPI implementation (Feb 2020 to Feb 2021) using segmented regression analysis. Changes in health care utilization and medical costs for each AIRD before and after NPI implementation were also investigated.
RESULTS: After NPI implementation, monthly incidence rates declined significantly by 0.205 per 1 000 000 (95% confidence interval [CI], -0.308 to -0.101, p < .001) in patients with systemic lupus erythematosus (SLE). No significant changes in the incidence of all AIRDs other than SLE were observed before and after implementation. Further, annual outpatient department visits per patient were lower during implementation for all diseases, except juvenile idiopathic arthritis (JIA). The prescription days per outpatient visit increased significantly during implementation for all diseases, except JIA and ankylosing spondylitis. During implementation, the total annual medical costs per patient tended to decrease for all diseases, except JIA and mixed connective tissue disease.
CONCLUSIONS: Implementation of NPIs to contain the pandemic led to a reduction in the incidence of SLE and changed patterns of medical care utilization and treatment cost for most AIRDs.
摘要：
背景：感染被认为是自身免疫性炎症性风湿性疾病（AIRD）的危险因素，其发病率被认为受到COVID-19大流行的影响。调查了非药物干预措施（NPI）对韩国AIRDs发生率及其相关医疗保健服务和医疗费用的影响。
方法：我们根据国家健康保险服务数据纳入了2016年1月至2021年2月期间报告的所有AIRD病例。我们使用分段回归分析评估了每个AIRD在NPI实施前后（2020年2月至2021年2月）的发病率趋势变化。还调查了实施NPI前后每个AIRD的医疗保健利用率和医疗费用的变化。
结果：NPI实施后，月发病率显着下降了0.205/1000(95%置信区间[CI]，系统性红斑狼疮（SLE）患者的-0.308至-0.101，p<.001）。在实施前后，除SLE以外的所有AIRDs的发生率均无明显变化。Further,在所有疾病的实施过程中，每位患者的年度门诊就诊次数较低，除了幼年特发性关节炎（JIA）。在所有疾病实施期间，每次门诊就诊的处方天数显着增加，除了JIA和强直性脊柱炎。在实施过程中,对于所有疾病，每位患者的年度医疗费用总额趋于下降，除了JIA和混合性结缔组织病。
结论：实施NPI以控制大流行导致SLE的发病率降低，并改变了大多数AIRDs的医疗服务利用模式和治疗成本。
方法：我们根据国家健康保险服务数据纳入了2016年1月至2021年2月期间报告的所有AIRD病例。我们使用分段回归分析评估了每个AIRD在NPI实施前后（2020年2月至2021年2月）的发病率趋势变化。还调查了实施NPI前后每个AIRD的医疗保健利用率和医疗费用的变化。
结果：NPI实施后，月发病率显着下降了0.205/1000(95%置信区间[CI]，系统性红斑狼疮（SLE）患者的-0.308至-0.101，p<.001）。在实施前后，除SLE以外的所有AIRDs的发生率均无明显变化。Further,在所有疾病的实施过程中，每位患者的年度门诊就诊次数较低，除了幼年特发性关节炎（JIA）。在所有疾病实施期间，每次门诊就诊的处方天数显着增加，除了JIA和强直性脊柱炎。在实施过程中,对于所有疾病，每位患者的年度医疗费用总额趋于下降，除了JIA和混合性结缔组织病。
结论：实施NPI以控制大流行导致SLE的发病率降低，并改变了大多数AIRDs的医疗服务利用模式和治疗成本。
