目的:本研究旨在获得与不同系统性红斑狼疮(SLE)人群中已验证的SLE病例的住院和急诊就诊相关的直接医疗费用的估计值。方法:格鲁吉亚人组织的抗狼疮(GOAL)队列是来自亚特兰大大都会的成年SLE患者的基于人群的队列,GA美国,有不同的SLE人口的地区。GOAL队列旨在研究健康的社会决定因素(SDoH)对患者相关结局的影响。医疗保健提供者,和政策制定者。对于这项研究,2011-2012年期间收集的调查数据与佐治亚州医院出院数据库(HDD)相关联,以捕获2012年至2013年整个佐治亚州的住院人数(HA)和急诊科就诊(EDV)。所有患者的直接医疗费用按HCU类型进行汇总,在那些实际访问的人中,以及社会人口统计学和医疗保健因素。结果:在829例患者中(94%为女性,78%黑色,64%的非私人保险,64%没有就业,平均年龄46岁),170(20.5%)和300(36.2%)参与者在1年的随访中至少有一个HA和一个EDV,分别,111(13.4%)同时具有HA和EDV。平均而言,每位患者经历了0.38HA和0.91EDV,每位患者的直接医疗费用为HAs14,968美元,EDV为3,022美元,每个HA39645美元,每个EDV3305美元。社会脆弱性较高或疾病较严重的患者对HA和EDV的收费较高(p<0.01),可能是由于延迟的护理和被忽视的健康需求导致更先进和昂贵的医疗。生活在联邦贫困水平以下与EDV的收费较高(p<0.001)有关,但与HAs的收费较低(p=0.036)有关。结论:本研究强调了SLE对弱势群体的经济负担,强调在医疗保健规划中纳入社会经济因素的重要性。政策努力应优先考虑减少获得护理和实施预防战略方面的差距。
UNASSIGNED: This study aimed to obtain estimates for the direct medical charges associated with
hospitalizations and emergency department visits of validated SLE cases in a diverse Systemic Lupus Erythematosus (SLE) population.
UNASSIGNED: The Georgians Organized Against Lupus (GOAL) cohort is a population-based cohort of adult SLE patients from metropolitan Atlanta, GA USA, an area having a diverse SLE population. The GOAL cohort aims to study the impact of social determinants of health (SDoH) on outcomes relevant to patients, healthcare providers, and policymakers. For this study, survey data collected during 2011-2012 was linked to the Georgia Hospital Discharge Database (HDD) to capture hospital admissions (HAs) and emergency department visits (EDVs) throughout Georgia from 2012 through 2013. Direct medical charges were summarized by HCU type among all patients, among those with actual visits, and by socio-demographics and healthcare factors.
UNASSIGNED: Among 829 patients (94% women, 78% Black, 64% non-private insurance, 64% not-employed, mean age of 46), 170 (20.5%) and 300 (36.2%) participants had at least one HA and one EDV in 1-year of follow-up, respectively, with 111(13.4%) having both HA and EDV. On average, each patient experienced 0.38 HAs and 0.91 EDVs, with per-patient direct medical charges of $14,968 for HAs & $3,022 for EDVs, and $39,645 per HA & $3,305 per EDV. Patients with higher social vulnerability or more severe disease had higher charges for both HA and EDV (p < 0.01), likely due to the delayed care and neglected health needs leading to more advanced and costly medical treatments. Living below the federal poverty level was associated with higher charges for EDVs (p < 0.001) but with lower charges for HAs (p = 0.036).
UNASSIGNED: This study underscores the economic burden of SLE on vulnerable populations, emphasizing the importance of including socio-economic factors in healthcare planning. Policy efforts should prioritize reducing disparities in access to care and implementing preventive strategies.