ArticleArthritis care & research2017
Disease Outcomes and Care Fragmentation Among Patients With Systemic Lupus Erythematosus.
Article in Arthritis care & research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The 2025 British Society for Rheumatology management recommendations for ANCA-associated vasculitis.Rheumatology (Oxford, England) · 2025Guideline
- Barriers for access and utilization of dementia care services in Europe: a systematic review.BMC geriatrics · 2025Pooled it
- The needs and unmet needs for people living with dementia, caregivers and care workers in dementia health care systems: a systematic review.Frontiers in public health · 2025Pooled it
- Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review.Arthritis care & research · 2024Pooled it
- Fragmented care and chronic illness patient outcomes: A systematic review.Nursing open · 2023Pooled it
- Outpatient Care Fragmentation and Patient Satisfaction With Care.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Perceptions of black women with systemic lupus erythematosus on continuity in care coordination: a mixed methods pilot study conducted in the USA.BMC musculoskeletal disorders · 2026Article
- Identifying High-Impact Solutions to Address Racial and Ethnic Health Disparities in Lupus: A Consensus-Based Approach.Arthritis care & research · 2026Article
- Screening for Social Determinants of Health in Patients With Systemic Lupus Erythematosus: A Point-of-Care Feasibility Study.Arthritis care & research · 2025Observational
- Criteria and Protocol: Assessing Generative AI Efficacy in Perceiving EULAR 2019 Lupus Classification.Diagnostics (Basel, Switzerland) · 2025Article
- Article
- Strategies for Creating Robust Patient Groups to Study Diverse Conditions with Electronic Health Records.Annual review of biomedical data science · 2025Review
- Data linkage multiplies research insights across diverse healthcare sectors.Communications medicine · 2025Review
- Dangers of Herpesvirus Infection in SLE Patients Under Anifrolumab Treatment: Case Reports and Clinical Implications.The American journal of case reports · 2024Article
- Towards an understanding of the biopsychosocial determinants of CVD in SLE: a scoping review.Lupus science & medicine · 2024Article
- Interpreting and Addressing Racialized Inequities in Rheumatic Disease Care and Outcomes.Arthritis care & research · 2024Article
- Privacy-preserving record linkage across disparate institutions and datasets to enable a learning health system: The national COVID cohort collaborative (N3C) experience.Learning health systems · 2024Article
- Identification and assessment of classification criteria attributes for systemic lupus erythematosus in a regional medical record data network.Lupus science & medicine · 2023Article
- Disparities in Lupus and the Role of Social Determinants of Health: Current State of Knowledge and Directions for Future Research.ACR open rheumatology · 2023Review
- Care Fragmentation Following Hospitalization for Atrial Fibrillation in the United States.JACC. Advances · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo examine the impact of care fragmentation across multiple health care institutions on disease outcomes in patients with systemic lupus erythematosus (SLE).
methodsUsing the Chicago HealthLNK Data Repository, an assembly of electronic health records from 6 institutions, we identified patients with SLE, using International Classification of Diseases, Ninth Revision (ICD-9) codes, whose care was delivered at more than 1 organization. We examined whether patients had severe infections or comorbidities (ICD-9 code defined) that indicated SLE-induced damage. T-tests and chi-square tests were used to examine differences between fragmentation groups. Logistic regression was used to assess factors contributing to the occurrence of disease outcomes.
resultsWe identified 4,276 patients with SLE. A total of 856 (20%) received care from more than 1 health care institution. African American patients and patients with public insurance were more likely to experience care fragmentation compared to white and private insurance patients (odds ratio [OR] 1.66, 95% confidence interval [95% CI] 1.44-1.97 and OR 1.63, 95% CI 1.42-1.95). We identified increased risk of infections (OR 1.57, 95% CI 1.30-1.88), cardiovascular disease (OR 1.51, 95% CI 1.23-1.86), end-stage renal disease (OR 1.34, 95% CI 1.05-1.70), nephritis (OR 1.28, 95% CI 1.07-1.54), and stroke (OR 1.28, 95% CI 1.01-1.62) among patients with fragmented care, adjusted for age, sex, race, insurance status, length of followup time, and total visit count.
conclusionIn this cross-site cohort of SLE patients, care fragmentation is associated with increased risk of severe infection and comorbidities. These results suggest that improved health information exchange could positively impact outcomes for SLE patients.
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