What question did this study set out to answer?

This research aims to examine how systemic lupus erythematosus (SLE) affects various clinical and psychosocial outcomes, along with healthcare resource use and costs.

February 26, 2026

Association of systemic lupus erythematosus with clinical and psychosocial outcomes, health care resource utilization and expenditures: A nationally representative US-based analysis

Key Points

This research aims to examine how systemic lupus erythematosus (SLE) affects various clinical and psychosocial outcomes, along with healthcare resource use and costs.
Conducted a retrospective US population-based cross-sectional study.
Used 2017-2022 Medical Expenditure Panel Survey data.
Identified SLE patients via self-reports and medication or specialist visits.
Matched eight non-SLE patients to each SLE patient based on survey year, age, and sex.
Performed multivariable regressions to assess associations between SLE and outcomes.
SLE patients had lower mean physical component summary scores than non-SLE patients by almost five points.
Higher odds of pain interference, fair to poor physical health, cognitive and functional limitations, social limitations, and psychological distress were found in SLE patients.
SLE patients had higher rates of outpatient visits, office-based visits, and emergency room visits.
Average annual healthcare expenditures for SLE patients were $18,566, compared to $9,366 for non-SLE patients.

Abstract

Background Limited information is available on the effect of systemic lupus erythematosus (SLE) on outcomes, and healthcare resource utilization and expenditures. Such evidence can help improve care for patients with SLE. Objectives We examined the associations between SLE and clinical and psychosocial outcomes, healthcare resource utilization, and direct healthcare expenditures. Methods We conducted a retrospective US population-based cross-sectional study using the US 2017–2022 Medical Expenditure Panel Survey data. We identified patients with SLE as those who both self-reported SLE diagnosis and either reported SLE-related medication use and/or visited a rheumatologist in the survey year. We matched eight patients without SLE to each patient with SLE on survey year, age, and sex, to create a reference cohort. The outcomes we assessed included clinical outcomes, psychosocial outcomes, healthcare resource utilization, and direct healthcare expenditures. We conducted appropriate multivariable regressions to examine the associations between SLE and each outcome. Results Patients with SLE had significantly lower mean physical component summary (PCS) scores than those without SLE by almost five points (p <. 0001). Patients with SLE reported higher odds of pain interference with activities (adjusted odds ratio (AOR) = 1. 998, 95% confidence interval (CI): 1. 372–2. 909), fair to poor physical health status (AOR = 3. 141, 95% CI: 1. 993–4. 949), cognitive limitations (AOR = 2. 665, 95% CI: 1. 465–4. 849), functional limitations (AOR = 2. 594, 95% CI: 1. 646–4. 089), social limitations (AOR = 2. 227, 95% CI: 1. 437–3. 451), and psychological distress (AOR = 2. 023, 95% CI: 1. 447–2. 827). Likewise, patients with SLE had higher adjusted rates of outpatient visits (adjusted annualized event rate ratio (AAERR) = 2. 603, p <. 05), office-based visits (AAERR = 1. 447, p <. 05), and emergency room visits (AAERR = 1. 518, p <. 05). Regarding healthcare expenditures, those with SLE had significantly higher average annual healthcare expenditures than those without SLE (18, 566 vs 9, 366, p <. 0001), and the findings were consistent across each healthcare resource component. In the adjusted analyses, average annual healthcare expenditures for individuals with SLE were significantly higher than those without SLE (13, 664 vs 11, 781, p <. 05). Conclusion Poor physical HRQoL, increased cognitive and functional limitations, and psychological distress are common among patients with SLE. Healthcare professionals across different disciplines should address these issues during visits and provide appropriate support and resources for patients with SLE. We also found higher healthcare resource utilization and higher healthcare expenditures among patients with SLE than their non-SLE counterparts.

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