AB0646 HEALTHCARE UTILIZATION AMONG INCIDENT CASES OF SYSTEMIC SCLEROSIS: RESULTS FROM A POPULATION-BASED COHORT (1988–2016)
Authors: Caitrin Coffey, Avneek Singh Sandhu, Cynthia S. Crowson, Dennis Asante, Eric Matteson, Thomas G. Osborn, Kenneth J. Warrington, Ashima Makol
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Systemic sclerosis (SSc) is an autoimmune disorder associated with multi-organ dysfunction including but not limited to vascular, cardiac and pulmonary involvement. Few studies have estimated the healthcare resource usage of patients with SSc. <h3>Objectives:</h3> To compare healthcare utilization among incident cases of SSc vs age- and sex-matched comparators. <h3>Methods:</h3> This study utilized a retrospective, population-based cohort of physician-diagnosed patients with SSc in a geographically well-defined area from Jan 1, 1988 to Dec 31, 2016. A 2:1 cohort of age- and sex-matched non-SSc subjects from the same population base was randomly selected for comparison. Inpatient and outpatient utilization data were obtained from the Rochester Epidemiology Project beginning 12 months prior to the SSc incidence/index date. Patients were followed until death, migration from Olmsted County, or December 31, 2017. A maximum of 5 years following the incidence/index date was used for analysis and the follow-up of each matched triple was further truncated at the shortest length of follow-up for any member, to ensure similar periods of observation for SSc cases and non-SSc comparators. Services were summarized as visit-days (number of days at least one service in the category was billed) to avoid overestimation of services provided. Utilization was compared between SSc and non-SSc cohorts using negative binomial models. <h3>Results:</h3> <b>The cohort included 69 incident SSc cases and 138 non-SSc comparators (mean age of</b> 57 ± 16 years at diagnosis/index, 90% female for both cohorts; 87% [SSc] and 95% [non-SSc] Caucasian). Patients with SSc had the highest utilization of outpatient physician, laboratory and combined radiology visit-days during the year of the SSc diagnosis compared with the year prior to diagnosis or years 1-4 after diagnosis of SSc (Table). Patients with SSc had higher utilization of outpatient physician, laboratory and combined radiology visit-days annually for the year prior to diagnosis of SSc and for each of the first 5 years after diagnosis of Ssc compared to patients without SSc. Rate ratios comparing utilization in patients with and without SSc ranged from 1.8 to 3.0 for all comparisons. <h3>Conclusion:</h3> A higher utilization of outpatient physician, laboratory and radiology visits 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. <h3>Disclosure of interests:</h3> Caitrin Coffey: None declared, avneek Singh Sandhu: None declared, Cynthia S. Crowson: None declared, Dennis asante: None declared, Eric Matteson Grant/research support from: Eric Matteson has received research grants from Pfizer and Sun Pharmaceutical industries, Ltd. For work on the pathobiology of rheumatoid arthritis., Consultant for: Eric Matteson has received consultancy fees from Boehringer ingelheim for an advisory board., Thomas G. Osborn: None declared, Kenneth J Warrington : None declared, ashima Makol: None declared