title: Comorbid Conditions are Associated With Emergency Department Visits, Hospitalizations, and Medical Charges of Patients With Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The findings in this study indicated that comorbid conditions are associated with healthcare utilization and medical charges of patients with SLE.
authors.affiliation: 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.
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Han
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009329:Nebraska / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*