Economic impact, clinical features and outcomes of hospitalised patients with SLE in India
Background: Systemic lupus erythematosus (SLE), a rare multisystem disorder with a female preponderance, has a high cost for the care; however, there is no evidence relevant to the Indian setting. The primary objective of our study was to determine the financial burden of the index admission (IA) a...
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SAGE Publishing
2023-01-01
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| Series: | Indian Journal of Rheumatology |
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| Online Access: | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2023;volume=18;issue=2;spage=126;epage=133;aulast=J. |
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| author | Mogalapu E J. Sumeir Tarun K George Vignana Sandeep Bonela Thenmozhi Mani John Mathew O C Abraham Mohan Jambugulam |
| author_facet | Mogalapu E J. Sumeir Tarun K George Vignana Sandeep Bonela Thenmozhi Mani John Mathew O C Abraham Mohan Jambugulam |
| author_sort | Mogalapu E J. Sumeir |
| collection | DOAJ |
| description | Background: Systemic lupus erythematosus (SLE), a rare multisystem disorder with a female preponderance, has a high cost for the care; however, there is no evidence relevant to the Indian setting. The primary objective of our study was to determine the financial burden of the index admission (IA) and subsequent costs during follow-up and ascertain the proportion with a catastrophic health expenditure (CHE).
Methodology: This was an observational retrospective cohort study where inpatients of a general medicine ward were recruited from January 2019 to October 2020. Clinical details and costs were obtained from the hospital's electronic records and bills. Patients were telephonically interviewed for follow-up clinical details and costs incurred. A patient-family payer perspective was used. Linear regression analysis was used.
Results: Of the 73 patients recruited during the study period, 96% were females and the majority (71%) were admitted through casualty, with 59% of patients having high disease activity (SLE Disease Activity Index >12). The hospital mortality was 9.6%. After a median follow-up of 12 months, there was good quality of life with no difference between the two severity groups. The total cost of the IA was 135,768 INR (94,053–223,954) and it was higher for the severe disease group (P = 0.038). The direct medical costs compromised 83% of admission costs. In the multivariate regression, the duration of hospital and intensive care unit stay were predictors of high cost. The median 6 months follow-up cost was 32,978 (14,240–80,940) and the total calculated annualized cost was 202,124 (136,188–331,508), which was not statistically different between the two groups. There was a CHE among 86% of patient-families.
Conclusion: This study demonstrates that there is high morbidity and cost involved in the management of a flare of SLE. However, with appropriate care, there are reasonably good outcomes and quality of life beyond six months. |
| format | Article |
| id | doaj-art-e0e9d4dfd1d74ca49ea26e45a8a0b27d |
| institution | OA Journals |
| issn | 0973-3698 0973-3701 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | SAGE Publishing |
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| series | Indian Journal of Rheumatology |
| spelling | doaj-art-e0e9d4dfd1d74ca49ea26e45a8a0b27d2025-08-20T01:47:45ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012023-01-0118212613310.4103/injr.injr_30_22Economic impact, clinical features and outcomes of hospitalised patients with SLE in IndiaMogalapu E J. SumeirTarun K GeorgeVignana Sandeep BonelaThenmozhi ManiJohn MathewO C AbrahamMohan JambugulamBackground: Systemic lupus erythematosus (SLE), a rare multisystem disorder with a female preponderance, has a high cost for the care; however, there is no evidence relevant to the Indian setting. The primary objective of our study was to determine the financial burden of the index admission (IA) and subsequent costs during follow-up and ascertain the proportion with a catastrophic health expenditure (CHE). Methodology: This was an observational retrospective cohort study where inpatients of a general medicine ward were recruited from January 2019 to October 2020. Clinical details and costs were obtained from the hospital's electronic records and bills. Patients were telephonically interviewed for follow-up clinical details and costs incurred. A patient-family payer perspective was used. Linear regression analysis was used. Results: Of the 73 patients recruited during the study period, 96% were females and the majority (71%) were admitted through casualty, with 59% of patients having high disease activity (SLE Disease Activity Index >12). The hospital mortality was 9.6%. After a median follow-up of 12 months, there was good quality of life with no difference between the two severity groups. The total cost of the IA was 135,768 INR (94,053–223,954) and it was higher for the severe disease group (P = 0.038). The direct medical costs compromised 83% of admission costs. In the multivariate regression, the duration of hospital and intensive care unit stay were predictors of high cost. The median 6 months follow-up cost was 32,978 (14,240–80,940) and the total calculated annualized cost was 202,124 (136,188–331,508), which was not statistically different between the two groups. There was a CHE among 86% of patient-families. Conclusion: This study demonstrates that there is high morbidity and cost involved in the management of a flare of SLE. However, with appropriate care, there are reasonably good outcomes and quality of life beyond six months.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2023;volume=18;issue=2;spage=126;epage=133;aulast=J.costeconomicindialupusmortalityoutcomesquality of lifesystemic lupus erythematosus |
| spellingShingle | Mogalapu E J. Sumeir Tarun K George Vignana Sandeep Bonela Thenmozhi Mani John Mathew O C Abraham Mohan Jambugulam Economic impact, clinical features and outcomes of hospitalised patients with SLE in India Indian Journal of Rheumatology cost economic india lupus mortality outcomes quality of life systemic lupus erythematosus |
| title | Economic impact, clinical features and outcomes of hospitalised patients with SLE in India |
| title_full | Economic impact, clinical features and outcomes of hospitalised patients with SLE in India |
| title_fullStr | Economic impact, clinical features and outcomes of hospitalised patients with SLE in India |
| title_full_unstemmed | Economic impact, clinical features and outcomes of hospitalised patients with SLE in India |
| title_short | Economic impact, clinical features and outcomes of hospitalised patients with SLE in India |
| title_sort | economic impact clinical features and outcomes of hospitalised patients with sle in india |
| topic | cost economic india lupus mortality outcomes quality of life systemic lupus erythematosus |
| url | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2023;volume=18;issue=2;spage=126;epage=133;aulast=J. |
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