Hospital Healthcare Resource Utilization and Associated Hospital Costs of Patients With Lupus Nephritis in China: A National Administrative Claim Database Study

Objectives

Assess hospital healthcare resource utilization (HCRU) and associated hospital costs of patients with lupus nephritis (LN) in China and compare these outcomes with a systemic lupus erythematosus (SLE) cohort (SLE with/without LN) as well as exploring the effect of end-stage kidney disease (ESKD).

Methods

This retrospective administrative claims-based analysis identified patients with SLE and SLE with LN from China using diagnosis codes and keywords. Patients with LN were subcategorized by presence of ESKD. Outcomes included all-cause and disease-specific HCRU (defined as healthcare visits including inpatient and outpatient visits) and medical costs (in 2022 US dollars).

Results

In total, 3645 patients with SLE were included, of whom 404 (11%) had LN. Among those with LN, 142 (35%) had ESKD. Median (interquartile range) all-cause healthcare visits per patient per month (PPPM) was significantly greater for patients with LN (2.08 [4.01]) vs SLE (0.92 [1.64]; P < .0001). Patients with LN and ESKD (3.00 [4.18]) had numerically more all-cause healthcare visits PPPM compared with LN patients without ESKD (1.50 [3.45]). Median all-cause costs PPPM were significantly greater among patients with LN ($287.46 [477.15]) vs SLE ($113.09 [267.39]; P < .0001) and numerically higher for patients with LN and ESKD ($466.29 [958.90]) vs LN without ESKD ($223.50 [319.56]).

Conclusions

Chinese patients with LN had greater HCRU and hospital healthcare costs compared with the general SLE cohort. This burden was higher for those with ESKD. These data highlight the substantial HCRU among patients with LN in China, especially those with ESKD, suggesting the need for early diagnosis and timely management of LN to mitigate the economic burden.