Objective

Systemic sclerosis (SSc) is a complex, heterogeneous connective tissue disease with multiorgan dysfunction. This study aimed to compare healthcare utilization among incident cases of SSc versus age- and gender-matched comparators.

Method

A population-based cohort of physician-diagnosed patients with SSc in Olmsted County, MN, USA, from 1 January 1988 to 31 December 2016 was assembled. A 2:1 cohort of age- and gender-matched non-SSc subjects was randomly selected for comparison. Patients were followed until death, migration from Olmsted County, or 31 December 2017. Outpatient utilization data were obtained beginning 12 months before the SSc incidence/index date and compared using negative binomial and multinomial models. Services were summarized as visit-days to avoid overestimation of services provided.

Results

The study included 69 incident SSc cases and 138 non-SSc comparators (mean ± sd age 57 ± 16 years at diagnosis/index, 90% female). Patients with SSc had higher utilization of outpatient physician, laboratory, and combined radiology visit-days annually for the year before and for each of the first 5 years after diagnosis than comparators. Among patients with SSc, healthcare utilization was highest during the year of SSc diagnosis. Rate ratios comparing utilization in patients with and without SSc ranged from 1.8 to 3.0 for all comparisons.

Conclusion

Higher utilization of outpatient physician, laboratory, and radiology visit-days was observed among patients with SSc compared to non-SSc subjects throughout 5 years of disease duration, indicating high and continued care needs in this patient population. The highest utilization of services among SSc patients occurred during the year of SSc diagnosis.

中文翻译：

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系统性硬化症发病病例中的门诊医疗保健利用率：基于美国人群的队列结果（1988-2016）

客观的

系统性硬化症（SSc）是一种复杂的异质性结缔组织疾病，伴有多器官功能障碍。本研究旨在比较 SSc 事件病例与年龄和性别匹配的对照者的医疗保健利用率。

方法

收集了 1988 年 1 月 1 日至 2016 年 12 月 31 日期间美国明尼苏达州奥姆斯特德县医生诊断的 SSc 患者的人群队列。随机选择年龄和性别匹配的非 SSc 受试者 2:1 队列进行比较。对患者进行随访，直至死亡、从奥姆斯特德县迁移或 2017 年 12 月 31 日。在 SSc 发病率/指数日期前 12 个月开始获取门诊患者利用数据，并使用负二项式和多项式模型进行比较。服务被总结为访问天数，以避免高估所提供的服务。

结果

该研究包括 69 例 SSc 病例和 138 例非 SSc 对照者（平均±标准差诊断/指数年龄 57±16 岁，90% 为女性）。与对照组相比，SSc 患者在诊断前一年和诊断后前 5 年每年门诊医生、实验室和综合放射科就诊日的利用率更高。在 SSc 患者中，诊断 SSc 当年的医疗保健利用率最高。所有比较中，患有和不患有 SSc 的患者的利用率在 1.8 到 3.0 之间变化。

结论

在整个 5 年的病程中，与非 SSc 受试者相比，SSc 患者的门诊医生、实验室和放射科就诊日的利用率更高，这表明该患者群体对持续护理的需求较高。SSc 患者的服务利用率最高发生在 SSc 诊断当年。