Healthcare and economic burden of ANCA-associated vasculitis in Italy: an integrated analysis from clinical and administrative databases

Quartuccio, Luca; Treppo, Elena; Valent, Francesca; Vita, Salvatore De

doi:10.1007/s11739-020-02431-y

Cited by 14 publications

(15 citation statements)

References 41 publications

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“…Studies available only compared hospitalization cost and charges of GPA hospitalizations vs. non-GPA hospitalizations. GPA hospitalizations were associated with higher healthcare expenditure as demonstrated by increased adjusted mean total hospital cost of $5,125 (95% CI: 4,719-5,531) and adjusted mean total hospital charges of $16,841 (95% CI: 15,280-18,403) compared to hospitalizations without GPA [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database

Idolor¹,

Guraya

Muojieje

et al. 2021

Cureus

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Background This study aims to compare outcomes of hospitalizations of granulomatosis with polyangiitis (GPA) with and without renal involvement. The primary outcome was inpatient mortality, whereas secondary outcomes were hospital length of stay (LOS) and total hospital charge. Methods Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 databases. The NIS was searched for GPA hospitalizations with and without renal involvement as the principal or secondary diagnosis using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) codes. GPA hospitalizations for adult patients from the above groups were identified. Multivariate logistic and linear regression analyses were used to adjust for possible confounders for the primary and secondary outcomes, respectively. Results There were more than 71 million discharges included in the combined 2016 and 2017 NIS database, of which 23,670 were for adult patients who had either a principal or secondary ICD-10 code for GPA, and 8,265 (34.92%) of these GPA hospitalizations had renal involvement. Hospitalizations for GPA with renal involvement had similar inpatient mortality (3.8% vs. 3.7%; adjusted OR: 1.14; 95% CI: 0.84-1.56; p=0.406) compared to those without renal involvement. GPA with renal involvement hospitalizations had an increase in adjusted mean LOS of 1.36 days (95% CI: 0.82-1.91; p=0.0001) compared to those without renal involvement. GPA with renal involvement hospitalizations had an increase in adjusted total hospital charges of $18,723 (95% CI: 9,595-27,852; p=0.0001) compared to those without renal involvement. Conclusions GPA with renal involvement hospitalizations had similar inpatient mortality compared to those without renal involvement. However, LOS and total hospital charges were greater in those with renal involvement.

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Section: Discussionmentioning

confidence: 99%

Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database

Idolor¹,

Guraya

Muojieje

et al. 2021

Cureus

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“…The costs were significantly higher than the ones we report here during the first 12 months for AAV patients with a median of €16,169. Recently, an Italian group reported a total COI of AAV patients to be €6168 per patient-year during follow-up of 8 years [27]. This emphasizes the need for more studies to gather information from different health care systems.…”

Section: Discussionmentioning

confidence: 99%

The Delay and Costs of Diagnosing Systemic Vasculitis in a Tertiary-Level Clinic

2020

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Introduction The diagnosis of systemic vasculitis is a challenge because of the heterogeneity of clinical manifestations. The aim of this study is to analyze the diagnostic delay in systemic vasculitis, the total costs during the first year of care, and how the diagnostic delay affects the costs in a tertiary health care facility. Methods Patients with a new diagnosis of systemic vasculitis between 2010 and 2018 were identified from hospital records. The diagnostic delay and health care costs were evaluated during the diagnostic period and within 12 months after the first contact with tertiary health care. Vasculitis-related costs were recorded as true costs charged. A total of 317 patients fulfilled the study criteria. The diagnoses were grouped into three clinically relevant groups: IgA vasculitis and other small-vessel vasculitis ( n = 64), ANCA-associated vasculitis (AAV) ( n = 112), and large-vessel vasculitis (LVV) ( n = 141). Results The diagnostic delay from the first referral to tertiary-level clinic was shortest in the LVV group and longest in the AAV group . Total costs during the diagnostic period were the highest in the AAV group (median = €6754 [IQR €8812]) and lowest in the LVV group (median = €3123 [IQR €4517]), p < 0.001. There was a significant positive correlation between the diagnostic delay and total costs during the diagnostic period and 12 months ( r s = 0.38, p < 0.001 and r s = 0.34, p < 0.001, respectively). In a linear model, the inpatient days and the number of laboratory tests were the strongest predictors ( p < 0.001) of a higher treatment cost during the diagnostic period. Conclusions There is a substantial diagnostic delay that correlates significantly with the costs in tertiary-level health care when diagnosing systemic vasculitis. Electronic supplementary material The online version of this article (10.1007/s40744-020-00266-9) contains supplementary material, which is available to authorized users.

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“…The worldwide reported prevalence of AAV ranges from 4.6 to 21.8 cases per one million person-years (5)(6)(7). Most studies agree that its incidence increases over time (5,8,9).…”

Section: Prevalencementioning

confidence: 99%

Diagnostic and Therapeutic Approach in ANCA-Associated Glomerulonephritis: A Review on Management Strategies

2022

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Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a destructive small vessel vasculitis affecting multiple organs. Renal involvement often leads to end-stage renal disease and increases mortality. Prompt diagnosis and initiation of adequate immunosuppressive therapy are critical for the best patient and kidney outcomes. However, considerable heterogeneity in symptoms and severity across the patients frequently hinder the diagnosis and management. The objective of this review is to emphasize the heterogeneity of the ANCA-associated vasculitis, facilitate the recognition and give guidance to the therapeutical possibilities. We present epidemiologic and risk factors, pathogenesis, and provide comprehensive clinical features of the disease. This article also focuses on the currently available therapeutic options and emerging cellular and molecular targets for the management of systemic and especially renal disease. We conducted extensive literature research published on PubMed and Google Scholar. We systematically reviewed, analyzed, and assembled databases, covering a broad spectrum of aspects of the disease. We compared and summarized the recommendations of two recent guidelines on ANCA-associated vasculitis. The incidence of ANCA-associated vasculitis, hence glomerulonephritis shows a steady increase. Familiarity with the presenting symptoms and laboratory abnormalities are necessary for rapid diagnosis. Early initiation of treatment is the key aspect for favorable patient and renal outcomes. A better understanding of the pathogenesis constantly leads to more targeted and therefore more efficient and less toxic treatment.

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Healthcare and economic burden of ANCA-associated vasculitis in Italy: an integrated analysis from clinical and administrative databases

Cited by 14 publications

References 41 publications

Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database

Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database

The Delay and Costs of Diagnosing Systemic Vasculitis in a Tertiary-Level Clinic

Diagnostic and Therapeutic Approach in ANCA-Associated Glomerulonephritis: A Review on Management Strategies

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