Han Guang-Ming, Han Xiao-Feng
From the *Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, PR China; †Nebraska Department of Health and Human Services, Lincoln, NE; and ‡Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE.
J Clin Rheumatol. 2017 Jan;23(1):19-25. doi: 10.1097/RHU.0000000000000437.
BACKGROUND/OBJECTIVES: In addition to increase mortality, comorbidities can increase medical costs for systemic lupus erythematosus (SLE). Healthcare utilization can dramatically increase medical costs. It is essential to better understand the comorbidities that can lead to healthcare utilization, such as emergency department visit and/or hospitalization, for SLE patients. Therefore, the objective of this study was to examine the associations between comorbidities and healthcare utilization and medical charges of patients with SLE.
Nebraska statewide emergency departments (ED) discharge and hospitals discharge data from 2007 to 2012 were used to study the comorbid conditions of patients with SLE. SLE was defined using the standard International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes (710.0).
There were more comorbid conditions in patients with SLE than patients without SLE. Comorbid conditions were majorly related to ED visits and hospitalizations of patients with SLE. Chest pain, abdominal pain, injury, acute respiratory infections, symptoms of digestive systems, headache, myalgia and myositis, noninfectious gastroenteritis and colitis, and symptoms of skin and other integumentary systems are common comorbid conditions for ED visits. Infections, cardiovascular diseases, fractures, chronic obstructive pulmonary disease (COPD) and allied conditions, cerebrovascular diseases, and episodic mood disorder are common comorbid conditions for hospitalizations of patients with SLE. In addition, the numbers of comorbid conditions were significantly associated with the length of hospital stay and hospital charges for SLE patients.
The findings in this study indicated that comorbid conditions are associated with healthcare utilization and medical charges of patients with SLE.
背景/目的：除了增加死亡率外，合并症还会增加系统性红斑狼疮（SLE）的医疗费用。医疗保健的使用会大幅增加医疗成本。更好地了解可能导致SLE患者医疗保健使用（如急诊就诊和/或住院）的合并症至关重要。因此，本研究的目的是探讨SLE患者合并症与医疗保健使用及医疗费用之间的关联。
利用2007年至2012年内布拉斯加州全州急诊室出院数据和医院出院数据研究SLE患者的合并症情况。SLE采用标准的《国际疾病分类》第九版临床修订本（ICD-9-CM）诊断编码（710.0）进行定义。
SLE患者的合并症比非SLE患者更多。合并症主要与SLE患者的急诊就诊和住院有关。胸痛、腹痛、损伤、急性呼吸道感染、消化系统症状、头痛、肌痛和肌炎、非感染性肠胃炎和结肠炎以及皮肤和其他皮肤系统症状是急诊就诊的常见合并症。感染、心血管疾病、骨折、慢性阻塞性肺疾病（COPD）及相关病症、脑血管疾病和发作性情绪障碍是SLE患者住院的常见合并症。此外，合并症的数量与SLE患者的住院时间和住院费用显著相关。
本研究结果表明，合并症与SLE患者的医疗保健使用和医疗费用相关。
