title: Annual medical costs and healthcare resource use in patients with systemic sclerosis in an insured population.
abstract: OBJECTIVE
  Systemic sclerosis (SSc) is a chronic autoimmune disease. The objective of our study was to estimate the medical costs and healthcare resource use of subjects with SSc in a large US managed care plan.
  
  
  METHODS
  Subjects at least 18 years of age and with claims-based evidence of SSc (ICD-9-CM code 710.1x) were identified from a health plan database from 2003 through 2008. Subjects were matched to unaffected controls, based on index date, age, sex, geographic region, time on insurance, and comorbidity score. Costs and resource use were identified during the 12-month postindex period. A generalized linear model (GLM) was used to estimate costs, controlling for demographic and clinical characteristics.
  
  
  RESULTS
  In this study, 1648 subjects with SSc were matched to 4944 controls. Mean overall annual medical costs were higher among SSc subjects than controls ($17,365 vs $5,508; p < 0.001). A GLM model supported these results. Evidence of lung disease, gastrointestinal bleeding, or renal disease increased costs (all p < 0.001). Compared to controls, significantly higher proportions of SSc subjects had postindex ambulatory visits, emergency department visits, and inpatient hospital stays (all p < 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that the medical costs and resource use associated with treating SSc are high (compared to matched controls), and as expected, subjects with serious disease complications experience the highest costs.
authors.affiliation: University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
authors.forename: Ancilla W
authors.initials: AW
authors.lastname: Fernandes
authors.forename: Serban R
authors.initials: SR
authors.lastname: Iorga
authors.forename: Warren
authors.initials: W
authors.lastname: Greth
authors.forename: Tim
authors.initials: T
authors.lastname: Bancroft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000191:economics / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007674:Kidney Diseases / Q000191:economics / Q000453:epidemiology; D016014:Linear Models; D008171:Lung Diseases / Q000191:economics / Q000453:epidemiology; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult