Health care utilization among patients with SLE decreased with time
Health care utilization was high for patients newly diagnosed patients with systemic lupus erythematosus, but declined with time. In addition, investigators found general practitioners were more likely to treat patients years after diagnosis.
Researchers identified patients with systemic lupus erythematosus (SLE) using seven case definitions in the Nova Scotia Medical Services Insurance database over a 13-year observation period. Patients with SLE were matched by age and sex with four control patients who had no history of connective tissue diseases and information in the database.
Significantly higher health care utilization was observed in patients with SLE compared to controls after analysis of visits to outpatient ambulatory assessments and inpatient consultations by general internists, family physicians, rheumatologists and other physicians. However, health care utilization was highest by patients with SLE in the first year of diagnosis and declined in the following years.
Visits to specialists decreased following the fourth assessment, with a 60% decrease in visits to a rheumatologist; a 50% decrease in visits to internal medicine specialists; and a 31% decrease to other physician groups. However, investigators found visits to family physicians decreased by 9%. Visits to family physicians remained high for patients with SLE during the study period.
Emergency room visits were more frequent among patients with SLE compared to control patients, with the highest frequency of visits in early disease and visits decreased with time.
“The findings were remarkably consistent,” the researchers wrote. “Regardless of the SLE case definition, physician encounters were highest in the year of diagnosis, trending lower in subsequent years but always remaining above those in matched controls.” - by Shirley Pulawski
Disclosures: Hanly reports honoraria from GlaxoSmithKline Canada and Roche Canada. Please see the full study for a list of all other authors’ relevant financial disclosures.