Journal article
The high frequency of healthcare use in patients one year prior to a sarcoidosis diagnosis
Sarcoidosis, vasculitis, and diffuse lung diseases, Vol.31(3), pp.256-261
10/20/2014
PMCID: PMC4315308
PMID: 25363229
Abstract
The clinical presentation of sarcoidosis can be varied. Prior investigations have shown that diagnosis is often delayed over six months, particularly in patients with pulmonary symptoms. Delays may lead to high healthcare use prior to diagnosis. To investigate healthcare use prior to diagnosis of sarcoidosis for a cohort of insured patients. We conducted a case-control study using a de-identified limited dataset of private health insurance claims. Cases were identified as persons with sarcoidosis from 2003-2009. Controls with other respiratory-related diagnoses (asthma, chronic obstructive pulmonary disease, pneumonia) were matched by age, gender, and diagnosis date. We compared frequencies of doctor visits, prescriptions, and imaging in the year prior to established diagnosis. We identified 206 cases and 2060 controls and compared healthcare use patterns in the year prior to diagnosis. Among those receiving prescriptions, a larger proportion of cases received two or more antibiotic courses (69% vs. 55%, p=0.0020) or two or more corticosteroid prescriptions (63% vs. 50%, p=0.0137). On average, cases had more doctor visits (14.7 vs. 7.8, p<0.0001), saw more specialties (3.9 vs. 2.1, p<0.0001), and underwent more chest x-rays (2.0 vs. 1.5, p<0.0001). A larger proportion of cases underwent two or more chest x-rays (54% vs. 24%, p<0.0001). Patients with sarcoidosis undergo a large amount of healthcare prior to diagnosis, some of which may not be necessary, compared to controls with respiratory-related disease. These results highlight the need for improved diagnostic algorithms to identify patients with sarcoidosis and avoid potentially excessive delays in diagnosis.
Details
- Title: Subtitle
- The high frequency of healthcare use in patients one year prior to a sarcoidosis diagnosis
- Creators
- Alicia K Gerke - Department of Internal Medicine: Pulmonary and Critical Care University of Iowa Hospitals and Clinics Iowa City, IA - 52242. alicia-gerke@uiowa.eduFan TangJane PendergastJoseph E CavanaughPhilip M Polgreen
- Resource Type
- Journal article
- Publication Details
- Sarcoidosis, vasculitis, and diffuse lung diseases, Vol.31(3), pp.256-261
- PMID
- 25363229
- PMCID
- PMC4315308
- NLM abbreviation
- Sarcoidosis Vasc Diffuse Lung Dis
- ISSN
- 1124-0490
- Publisher
- Italy
- Grant note
- K23 HL114640 / NHLBI NIH HHS
- Language
- English
- Date published
- 10/20/2014
- Academic Unit
- Statistics and Actuarial Science; Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Epidemiology; Biostatistics; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9983985919502771
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