Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study
Abstract Introduction Axial spondyloarthritis (axSpA) is a chronic inflammatory condition associated with considerable pain and impaired health-related quality of life (HRQoL) for affected patients. Despite the documented increase in healthcare resource utilization (HRU) related to axSpA, few studie...
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Adis, Springer Healthcare
2025-01-01
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| Series: | Rheumatology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40744-024-00742-6 |
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| author | Laura Berbel-Arcobé María Aparicio Joan Calvet Marta Arévalo Annika Nack Xavier Juanola Elide Toniolo Stefano Maratia Luis Lizán Jordi Gratacós |
| author_facet | Laura Berbel-Arcobé María Aparicio Joan Calvet Marta Arévalo Annika Nack Xavier Juanola Elide Toniolo Stefano Maratia Luis Lizán Jordi Gratacós |
| author_sort | Laura Berbel-Arcobé |
| collection | DOAJ |
| description | Abstract Introduction Axial spondyloarthritis (axSpA) is a chronic inflammatory condition associated with considerable pain and impaired health-related quality of life (HRQoL) for affected patients. Despite the documented increase in healthcare resource utilization (HRU) related to axSpA, few studies have explored the impact of diagnostic delays on these outcomes. This study sought to determine the association between diagnostic delay of axial spondyloarthritis (axSpA) and costs in the 3 years after diagnosis. Methods This is a retrospective, observational study based on routine follow-up data from adult patients with confirmed axSpA diagnosis in three tertiary Spanish hospitals. Sociodemographic and clinical variables were collected at diagnosis. Direct and indirect healthcare costs were estimated from healthcare resource use (HRU) and productivity losses. The correlation between diagnostic delay and total healthcare costs was analyzed. Results Eighty-two patients (62.2% men; mean age: 39.3 years at diagnosis) were included, mostly with radiographic axSpA (r-axSpA) (67.1%). The mean (standard deviation, SD) diagnostic delay was 10.1 (9.3) years, with a median (interquartile range, IQR) of 5.4 (2.3, 17.2) years. The mean total healthcare cost per patient accumulated over 3 years was €25,812.6 (direct: €16,384.7; indirect: €9427.9). Patients with longer diagnostic delay (> 5.4 years) had 57% higher total healthcare cost (€31,717.7 vs. €20,188.7, p = 0.029) and higher disease activity at diagnosis (BASDAI score 4.7 vs. 3.4, p = 0.007) and after 3 years (3.9 vs. 2.9, p = 0.042) compared to those with shorter delay (≤ 5.4 years). Conclusions The diagnostic delay in axSpA remains high and is associated with an increase in healthcare costs post-diagnosis. Actions to reduce diagnostic delay should be prioritized by healthcare systems to potentially improve outcomes and reduce long-term costs. |
| format | Article |
| id | doaj-art-e2f1ddfbc6ee498d907ecfde0efea6a3 |
| institution | DOAJ |
| issn | 2198-6576 2198-6584 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Adis, Springer Healthcare |
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| series | Rheumatology and Therapy |
| spelling | doaj-art-e2f1ddfbc6ee498d907ecfde0efea6a32025-08-20T02:41:33ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842025-01-0112225526610.1007/s40744-024-00742-6Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational StudyLaura Berbel-Arcobé0María Aparicio1Joan Calvet2Marta Arévalo3Annika Nack4Xavier Juanola5Elide Toniolo6Stefano Maratia7Luis Lizán8Jordi Gratacós9Rheumatology Department, Bellvitge University Hospital, Hospitalet de LlobregatRheumatology Department, Germans Trias i Pujol University HospitalRheumatology Department, Parc Taulí University Hospital. Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de BarcelonaRheumatology Department, Parc Taulí University Hospital. Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de BarcelonaRheumatology Department, Germans Trias i Pujol University HospitalRheumatology Department, Bellvitge University Hospital, Hospitalet de LlobregatUCB PharmaUCB PharmaOutcomes’10Rheumatology Department, Parc Taulí University Hospital. Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de BarcelonaAbstract Introduction Axial spondyloarthritis (axSpA) is a chronic inflammatory condition associated with considerable pain and impaired health-related quality of life (HRQoL) for affected patients. Despite the documented increase in healthcare resource utilization (HRU) related to axSpA, few studies have explored the impact of diagnostic delays on these outcomes. This study sought to determine the association between diagnostic delay of axial spondyloarthritis (axSpA) and costs in the 3 years after diagnosis. Methods This is a retrospective, observational study based on routine follow-up data from adult patients with confirmed axSpA diagnosis in three tertiary Spanish hospitals. Sociodemographic and clinical variables were collected at diagnosis. Direct and indirect healthcare costs were estimated from healthcare resource use (HRU) and productivity losses. The correlation between diagnostic delay and total healthcare costs was analyzed. Results Eighty-two patients (62.2% men; mean age: 39.3 years at diagnosis) were included, mostly with radiographic axSpA (r-axSpA) (67.1%). The mean (standard deviation, SD) diagnostic delay was 10.1 (9.3) years, with a median (interquartile range, IQR) of 5.4 (2.3, 17.2) years. The mean total healthcare cost per patient accumulated over 3 years was €25,812.6 (direct: €16,384.7; indirect: €9427.9). Patients with longer diagnostic delay (> 5.4 years) had 57% higher total healthcare cost (€31,717.7 vs. €20,188.7, p = 0.029) and higher disease activity at diagnosis (BASDAI score 4.7 vs. 3.4, p = 0.007) and after 3 years (3.9 vs. 2.9, p = 0.042) compared to those with shorter delay (≤ 5.4 years). Conclusions The diagnostic delay in axSpA remains high and is associated with an increase in healthcare costs post-diagnosis. Actions to reduce diagnostic delay should be prioritized by healthcare systems to potentially improve outcomes and reduce long-term costs.https://doi.org/10.1007/s40744-024-00742-6Axial spondyloarthritisCostsDiagnostic delayDisease activityHealthcare resource utilization |
| spellingShingle | Laura Berbel-Arcobé María Aparicio Joan Calvet Marta Arévalo Annika Nack Xavier Juanola Elide Toniolo Stefano Maratia Luis Lizán Jordi Gratacós Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study Rheumatology and Therapy Axial spondyloarthritis Costs Diagnostic delay Disease activity Healthcare resource utilization |
| title | Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study |
| title_full | Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study |
| title_fullStr | Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study |
| title_full_unstemmed | Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study |
| title_short | Association Between Diagnostic Delay and Economic and Clinical Burden in Axial Spondyloarthritis: A Multicentre Retrospective Observational Study |
| title_sort | association between diagnostic delay and economic and clinical burden in axial spondyloarthritis a multicentre retrospective observational study |
| topic | Axial spondyloarthritis Costs Diagnostic delay Disease activity Healthcare resource utilization |
| url | https://doi.org/10.1007/s40744-024-00742-6 |
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