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Title: | Quantifying the direct public health care cost of systemic sclerosis. | Authors: | Rabusa C.;Ferdowsi N.;Nikpour M.;Proudman S.;Morrisroe K.;Hill C.;Stevens W.;Sahhar J. ;Ngian G.-S. | Institution: | (Morrisroe, Nikpour) Department of Medicine, University of Melbourne, St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, VIC 3065, Australia (Morrisroe, Stevens, Rabusa, Ferdowsi, Nikpour) Department of Rheumatology, St Vincent's Hospital (Melbourne), Australia (Sahhar, Ngian) Department of Medicine, Monash University, Clayton and Monash Health, VIC, Australia (Hill, Proudman) Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Australia (Hill) Rheumatology Unit, Queen Elizabeth Hospital, Woodville Road, Woodville, Australia (Hill, Proudman) Discipline of Medicine, University of Adelaide, SA, Australia | Issue Date: | 12-Dec-2017 | Copyright year: | 2017 | Publisher: | Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org) | Place of publication: | United States | Publication information: | Medicine (United States). 96 (48) (no pagination), 2017. Article Number: e8503. Date of Publication: 01 Dec 2017. | Journal: | Medicine | Abstract: | To quantify the direct healthcare cost of systemic sclerosis (SSc) and identify its determinants. Healthcare use was captured through data linkage, wherein clinical and medication data for SSc patients from the state of Victoria enrolled in the Australian Scleroderma Cohort Study were linked with the Victorian hospital admissions and emergency presentations data sets, and the Medicare Benefits Schedule which contains all government subsidized ambulatory care services, for the period 2011-2015. Medication cost was determined from the Pharmaceutical Benefits Scheme. Costs were extrapolated to all Australian SSc patients based on SSc prevalence of 21.1 per 100,000 and an Australian population of 24,304,682 in 2015. Determinants of healthcare cost were estimated using logistic regression. Total healthcare utilization cost to the Australian government extrapolated to all Australian SSc patients from 2011 to 2015 was Australian Dollar (AUD)$297,663,404.77, which is an average annual cost of AUD$59,532,680.95 (US Dollar [USD]$43,816,040.08) and annual cost per patient of AUD$11,607.07 (USD$8,542.80). Hospital costs, including inpatient hospitalization and emergency department presentations, accounted for the majority of these costs (44.4% of total), followed by medication cost (31.2%) and ambulatory care cost (24.4%). Pulmonary arterial hypertension (PAH) and gastrointestinal (GIT) involvement were the major determinants of healthcare cost (OR 2.3 and 1.8, P = .01 for hospitalizations; OR 2.8 and 2.0, P = .01 for ambulatory care; OR 7.8 and 1.6, P < .001 and P = .03 for medication cost, respectively). SSc is associated with substantial healthcare utilization and direct economic burden. The most costly aspects of SSc are PAH and GIT involvement.Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1097/MD.0000000000008503 | Link to associated publication: | Click here for full text options | PubMed URL: | 29310332 [http://www.ncbi.nlm.nih.gov/pubmed/?term=29310332] | ISSN: | 0025-7974 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38696 | Type: | Article | Subjects: | abatacept/pe [Pharmacoeconomics] ambrisentan/dt [Drug Therapy] ambrisentan/pe [Pharmacoeconomics] angiotensin receptor antagonist/dt [Drug Therapy] angiotensin receptor antagonist/pe [Pharmacoeconomics] antiarrhythmic agent/dt [Drug Therapy] antiarrhythmic agent/pe [Pharmacoeconomics] antibiotic agent/dt [Drug Therapy] antibiotic agent/pe [Pharmacoeconomics] antilipemic agent/dt [Drug Therapy] antilipemic agent/pe [Pharmacoeconomics] azathioprine/dt [Drug Therapy] azathioprine/pe [Pharmacoeconomics] beta adrenergic receptor blocking agent/dt [Drug Therapy] beta adrenergic receptor blocking agent/pe [Pharmacoeconomics] bosentan/dt [Drug Therapy] bosentan/pe [Pharmacoeconomics] cyclophosphamide/dt [Drug Therapy] cyclophosphamide/pe [Pharmacoeconomics] cyclosporin/dt [Drug Therapy] cyclosporin/pe [Pharmacoeconomics] dipeptidyl carboxypeptidase inhibitor/pe [Pharmacoeconomics] diuretic agent/dt [Drug Therapy] diuretic agent/pe [Pharmacoeconomics] histamine H2 receptor antagonist/dt [Drug Therapy] histamine H2 receptor antagonist/pe [Pharmacoeconomics] hydroxychloroquine/dt [Drug Therapy] hydroxychloroquine/pe [Pharmacoeconomics] iloprost/dt [Drug Therapy] iloprost/pe [Pharmacoeconomics] leflunomide/dt [Drug Therapy] leflunomide/pe [Pharmacoeconomics] macitentan/dt [Drug Therapy] macitentan/pe [Pharmacoeconomics] methotrexate/dt [Drug Therapy] methotrexate/pe [Pharmacoeconomics] mycophenolate mofetil/dt [Drug Therapy] mycophenolate mofetil/pe [Pharmacoeconomics] penicillamine/dt [Drug Therapy] penicillamine/pe [Pharmacoeconomics] prednisolone/dt [Drug Therapy] prednisolone/pe [Pharmacoeconomics] prostacyclin/pe [Pharmacoeconomics] proton pump inhibitor/dt [Drug Therapy] proton pump inhibitor/pe [Pharmacoeconomics] rituximab/dt [Drug Therapy] rituximab/pe [Pharmacoeconomics] sildenafil/dt [Drug Therapy] sildenafil/pe [Pharmacoeconomics] tadalafil/dt [Drug Therapy] tadalafil/pe [Pharmacoeconomics] tocilizumab/dt [Drug Therapy] tocilizumab/pe [Pharmacoeconomics] tumor necrosis factor inhibitor/dt [Drug Therapy] tumor necrosis factor inhibitor/pe [Pharmacoeconomics] unindexed drug prostacyclin/dt [Drug Therapy] ambulatory care article Australia cardiovascular disease/dt [Drug Therapy] data analysis drug cost economic aspect emergency care gastrointestinal disease/dt [Drug Therapy] *health care cost health care utilization hospital patient hospitalization cost human prevalence priority journal pulmonary hypertension/dt [Drug Therapy] quantitative analysis *systemic sclerosis/dt [Drug Therapy] systemic sclerosis/dt [Drug Therapy] abatacept/dt [Drug Therapy] hospital patient hospitalization cost human prevalence priority journal pulmonary hypertension / drug therapy quantitative analysis *systemic sclerosis / *drug therapy Australia Article ambulatory care systemic sclerosis / drug therapy cardiovascular disease / drug therapy data analysis drug cost economic aspect emergency care gastrointestinal disease / drug therapy *health care cost health care utilization |
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