Health Care Utilization in Systemic Lupus Erythematosus in the Community: The Lupus Midwest Network

Baptiste Chevet, Gabriel Figueroa-Parra, Maria O. Valenzuela-Almada, Mehmet Hocaoglu, Sebastian Vallejo, Shirley Ann Osei-Onomah, Rachel E. Giblon, Jesse Y. Dabit, Alanna Chamberlain, Divi Cornec, Kurt J. Greenlund, Kamil E. Barbour, Cynthia S. Crowson, Alí Duarte-García

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The aim of this study was to determine inpatient health care utilization in an incident cohort of patients with systemic lupus erythematosus (SLE) compared with the general population. Methods This was a population-based cohort study in the upper Midwest, United States. We included patients fulfilling the European League Against Rheumatism/American College of Rheumatology SLE classification criteria between 1995 and 2018. They were 1:1 age-, sex-, county-matched with individuals without SLE. All hospital admissions and emergency department (ED) visits were electronically retrieved for 1995-2020. Rates for hospital admission, length of stay, readmission, ED visits, and discharge destination were compared between groups. Results Three hundred forty-one patients with SLE and 341 comparators without SLE were included (mean age, 48.6 years at diagnosis; 79.2% female). Rates of hospitalization for patients with SLE and comparators were 29.8 and 9.9 per 100 person-years, respectively. These differences were present across sexes and age groups. Hospitalization rates were higher in patients with SLE after diagnosis and remained higher than comparators for the first 15 years of the disease. Patients with SLE were more likely than comparators to visit the ED (hazard ratio, 2.71; 95% confidence interval, 2.05-3.59). Readmission rates (32% vs. 21%, p = 0.017) were higher in patients with SLE. Length of stay and discharge destination were similar between both groups. Conclusion Patients with SLE were more likely to be hospitalized and to visit the ED than individuals without SLE, highlighting important inpatient care needs. Increased hospitalization rates were observed in both male and female patients and all age groups.

Original languageEnglish (US)
Pages (from-to)29-35
Number of pages7
JournalJournal of Clinical Rheumatology
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2023

Keywords

  • epidemiology
  • health care utilization
  • hospitalization
  • incidence
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

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