ArticleSeminars in arthritis and rheumatism2020
Patterns and predictors of recurrent acute care use among Medicaid beneficiaries with systemic lupus erythematosus.
Article in Seminars in arthritis and rheumatism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Article
- Sociodemographic profiles and organ damage accural in the Black Women's Experience Living with Lupus study.Lupus · 2024Article
- Article
- Frailty and emergency department utilisation in adults with systemic lupus erythematosus ≤65 years of age: an administrative claims data analysis of Medicaid beneficiaries.Lupus science & medicine · 2023Article
- A multi-step approach to develop a "storytelling" intervention to improve patient gout knowledge and improve outpatient follow-up.Contemporary clinical trials communications · 2023Article
- Health disparities in systemic lupus erythematosus-a narrative review.Clinical rheumatology · 2022Review
- Predictors of Initial Hydroxychloroquine Receipt Among Medicaid Beneficiaries With Incident Systemic Lupus Erythematosus.Arthritis care & research · 2022Article
- The Impact of an Integrated Care Management Program on Acute Care Use and Outpatient Appointment Attendance Among High-Risk Patients With Lupus.ACR open rheumatology · 2022Article
- Hydroxychloroquine in systemic lupus erythematosus: overview of current knowledge.Therapeutic advances in musculoskeletal disease · 2022Review
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Authors and funding
5 authors.
Funding
Abstract
objectivesWe aimed to identify longitudinal patterns and predictors of acute care use (emergency department [ED] visits and hospitalizations) among individuals with SLE enrolled in Medicaid, the largest U.S. public insurance.
methodsUsing Medicaid data (29 states, 2000-2010) we identified 18-65-year-olds with SLE (≥3 SLE ICD-9 codes, 3rd code=index date), ≥12 months of enrollment prior to the index date and ≥24 months post. For each 90-day interval post index date, patients were assigned binary indicators (1=≥1 ED visit or hospitalization, 0=none). We used group-based trajectory models to graph patterns of overall and SLE-specific acute care use, and multinomial logistic regression models to examine predictors.
resultsAmong 40,381 SLE patients, the mean age was 40.8 (SD 11.9). Using a three-group trajectory model, 2,342 (6%) were recurrent all-cause high acute care utilizers, 12,932 (32%) moderate, 25,107 (62%) infrequent; 25% were moderate or high utilizers for SLE. There were higher odds of all-cause, recurrent acute care use (vs. infrequent) among patients with severe vs. mild SLE (OR 3.37, 95% CI 3.0-3.78), chronic pain (odds ratio [OR] 1.63, 95% CI 1.15-2.32), depression (OR 1.90 95% CI 1.74-2.09), and cardiovascular disease (OR 2.29, 95% CI 2.08-2.52). Older age, male sex and hydroxychloroquine use were associated with lower odds of recurrent overall and SLE-specific acute care use.
conclusionNearly 40% of Medicaid beneficiaries with SLE are recurrent all-cause acute care utilizers; 25% have recurrent use for SLE. Modifiable factors, including outpatient management of SLE and comorbidities, may reduce avoidable acute care use.
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