A cohort of 306 patients was recruited. Questionnaire interview, review of medical records and clinical assessments were performed to obtain information regarding disease status, healthcare resources utilization and HRQoL. / Cost-of-illness studies measure the monetary burden that a disease imposes on society or individuals. The substantial financial burden of SLE has been demonstrated in a modest number of studies and a restricted number of countries. However, there is no study investigating the relationship between disease costs and NPSLE/flare. / In summary, this study has provided support for our hypotheses. The socioeconomic impact of SLE in Hong Kong is considerable. The presence of NPSLE and flare are significantly associated increase disease costs but not impaired HRQoL. These suggest that management, which can lead to early diagnosis and effectively control disease activity and prevent lupus flares, may reduce disease costs due to both healthcare consumption and loss of productivity. / Systemic lupus erythematosus (SLE) is a multi-factorial autoimmune disease that primarily affects young women, characterized by a chronic remitting-relapsing (flare) disease course. Central nervous system is one of the most common affect systems in SLE. Neuropsychiatrie SLE (NPSLE) is associated with impairment of quality of life, accumulated disease damage, disability and employment. Flare, an increase in disease activity over a defined period, is an important outcome in the assessment of SLE. Uncontrolled disease activity results in cumulative organ damage which is associated with increased mortality. / The main findings were as follows. 1. The average annual total costs were USD 13,307 (2006 US dollars) per patient. The direct costs dominated the total costs (62%), and the costs of inpatient care contributed 52% of the direct costs. Costs of SLE per subject are higher than those of other chronic diseases in Hong Kong. 2. Patients with NPSLE incurred significantly higher direct and indirect costs compared to those without NPSLE. The number of NPSLE event was an independent explanatory variable associated with both increased direct and indirect costs. 3. Annual direct costs and indirect costs were significantly higher in those with flares. The number of flare was an independent explanatory variable associated with increased direct costs. Patients with multi-organ flares or renal/neuropsychiatric flares incurred higher direct costs than those with single organ flare or those with minor organ flares. 4. Patients with SLE had significantly lower level of HRQoL compared with Hong Kong general population. The presence of NPSLE and flare only weakly associated with impairment of HRQoL. / The present thesis was a retrospective cost-of-illness study on Chinese patients in Hong Kong with SLE within working age, aiming to 1. estimate the direct and indirect costs of SLE from a societal perspective; 2. ascertain the relationship between NPSLE and direct and indirect costs; 3. ascertain the relationship between flare and direct and indirect costs; 4. investigate the relationship between HRQoL and NPSLE/flares. / We hypothesized that: I. SLE is associated with substantial socioeconomic burden as a result of NPSLE and flare; 2. patients with NPSLE or flares may experience more compromised health-related quality of life (HRQoL). / Zhu, Yaner. / Adviser: Edmund K. Li. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 190-214). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.
| Identifer | oai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_344499 |
| Date | January 2010 |
| Contributors | Zhu, Yaner., Chinese University of Hong Kong Graduate School. Division of Medical Sciences. |
| Source Sets | The Chinese University of Hong Kong |
| Language | English, Chinese |
| Detected Language | English |
| Type | Text, theses |
| Format | electronic resource, microform, microfiche, 1 online resource (xix, 223, [20] leaves : ill.) |
| Coverage | China, Hong Kong, Hong Kong |
| Rights | Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
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