title: Medical costs incurred by organ damage caused by active disease, comorbidities and side effect of treatments in systemic lupus erythematosus patients: a Taiwan nationwide population-based study.
abstract: This study aims to systematically investigate the medial expenditures incurred by systemic lupus erythematosus (SLE)-associated organ damages in order to assess the economic impact of damage accrual by active disease, comorbidities and side effect of treatments. In total, 22,258 SLE cases were identified from the National Health Insurance Research Database, and organ damages assessed were according to the list from Systemic Lupus International Collaborative Clinic/American Rheumatology damage index system. Medical expenditures incurred by organ damages in the first as well as the subsequent year were obtained from the database. Our data reflected that organ damages caused by active disease and comorbidities, such those of renal, neuropsychiatric, pulmonary and cardiovascular systems are among the highest costing of all damage items. This study also shows that significant medical expenditures are incurred by damage items such as those occurring in ocular and musculoskeletal systems, which are typically caused by side effect of treatments such as corticosteroids. The medical expenditure in subsequent year still causes substantial economic burden. This systematic and continuous survey provided important reference of disease burden of SLE.
authors.affiliation: Department of Allergy, Immunology and Rheumatology, Changhua Christian Hospital, Changhua City, Changhua County, Taiwan.|Department of Nursing, College of Medicine and Nursing, HungKuang University, Taichung, Taiwan.
authors.forename: Y M
authors.initials: YM
authors.lastname: Chiu
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: M T
authors.initials: MT
authors.lastname: Chuang
authors.affiliation: Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei, 112, Taiwan. hclang@ym.edu.tw.
authors.forename: H C
authors.initials: HC
authors.lastname: Lang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D017281:Cost of Illness; D016208:Databases, Factual; D017048:Health Care Costs; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*; D012720:Severity of Illness Index; D013624:Taiwan
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Medical expenditures; National Health Insurance; Organ damage; Systemic lupus erythematosus