Background
Methods
Data source
Identification of JDM
Data processing and statistics
Results
Juvenile dermatomyositis patient and hospital characteristics
Variable | Primary diagnosis of JDM | |||||||
---|---|---|---|---|---|---|---|---|
No | Yes | |||||||
Freq | Row Percent [95% CI] | Freq | Percent [95% CI] | Crude OR [95% CI] |
P
| Adjusted OR [95% CI] |
P
| |
Age | ||||||||
0–5 | 12,470,783 | 55.00 [54.35–55.64] | 1077 | 25.18 [19.85–30.52] | Reference | – | Reference | – |
6–11 | 3,371,272 | 14.87 [14.65–15.09] | 1686 | 39.42 [33.59–45.25] | 5.79 [4.23–7.93] | <.0001 | 4.62 [4.18–5.10] | <.0001 |
11–17 | 6,832,983 | 30.13 [29.47–30.80] | 1514 | 35.39 [29.87–40.91] | 2.565 [1.872–3.514] | <.0001 | 1.86 [1.67–2.06] | <.0001 |
Season | ||||||||
Fall | 5,305,485 | 25.01 [24.89–25.14] | 958 | 25.29 [21.95–28.64] | 1.21 [0.97–1.52] | 0.0980 | 1.18 [1.06–1.33] | 0.004 |
Winter | 6,135,926 | 28.93 [28.69–29.17] | 916 | 24.18 [20.81–27.54] | Reference | – | Reference | – |
Spring | 5,007,154 | 23.61 [23.51–23.71] | 892 | 23.53 [20.49–26.57] | 1.19 [0.97–1.46] | 0.0931 | 1.13 [1.01–1.27] | 0.0349 |
Summer | 4,761,755 | 22.45 [22.29–22.61] | 1023 | 27.00 [23.73–30.27] | 1.44 [1.15–1.80] | 0.0015 | 1.53 [1.37–1.71] | <.0001 |
Gender | ||||||||
Female | 10,343,988 | 54.16 [54.03–54.30] | 2753 | 64.74 [59.70–69.70] | 2.170 [1.739–2.708] | <.0001 | 2.22 [2.05–2.42] | <.0001 |
Male | 12,222,939 | 45.84 [45.70–45.97] | 1499 | 35.26 [30.21–40.30] | Reference | – | Reference | – |
Race | ||||||||
White | 9,127,707 | 51.60 [49.63–53.57] | 1712 | 51.83 [43.21–60.45] | Reference | – | Reference | – |
Black | 2,970,647 | 16.79 [15.48–18.11] | 529 | 16.02 [11.32–20.71] | 0.949 [0.650–1.388] | 0.7889 | 0.83 [0.73–0.94] | 0.0026 |
Hispanic | 3,975,465 | 24.47 [20.45–24.50] | 811 | 24.56 [17.39–31.72] | 1.088 [0.731–1.619] | 0.6781 | 1.01 [0.91–1.13] | 0.8044 |
Other | 1,615,416 | 9.13 [8.24–10.03] | 251 | 7.60 [3.71–11.48] | 0.828 [0.462–1.485] | 0.5271 | 0.60 [0.51–0.71] | <.0001 |
Insurance | ||||||||
Medicaid | 10,669,493 | 46.42 [45.17–47.66] | 1530 | 35.47 [30.99–39.95] | 0.658 [0.538–0.805] | <.0001 | 0.71 [0.65–0.78] | <.0001 |
Private insurance | 10,435,364 | 45.40 [44.06–46.74] | 2273 | 52.71 [47.02–58.40] | Reference | – | Reference | – |
Self-pay | 855,164 | 3.72 [3.28–4.16] | 105 | 2.44 [0.21–4.66] | 0.564 [0.226–1.408] | 0.2197 | 0.57 [0.43–0.76] | <.0001 |
No charge | 43,330 | 0.19 [0.12–0.26] | 9 | 0.20 [0.00–0.48] | 0.903 [0.226–3.606] | 0.8850 | 1.91 [0.97–3.76] | 0.0595 |
Non-Medicaid government program | 888,190 | 3.86 [3.53–4.20] | 396 | 9.18 [5.08–13.29] | 2.047 [1.253–3.344] | 0.0043 | 2.59 [2.26–2.97] | <.0001 |
Number of Chronic Conditions | ||||||||
0–1 | 16,472,397 | 71.53 [70.36–72.70] | 2479 | 57.42 [50.81–64.03] | Reference | – | Reference | – |
2 to 5 | 5,928,336 | 25.74 [24.77–26.72] | 1682 | 38.96 [33.40–44.52] | 1.885 [1.451–2.449] | <.0001 | 1.41 [1.30–1.54] | <.0001 |
6+ | 627,835 | 2.73 [2.48–2.97] | 156 | 3.62 [1.47–5.76] | 1.653 [0.844–3.236] | 0.1426 | 1.24 [1.00–1.52] | 0.046 |
Hospital Location | ||||||||
Metropolitan >1million | 7,153,680 | 37.36 [33.68–41.04] | 19,300 | 51.32 [40.24–62.41] | Reference | – | Reference | – |
Fringe/Metro < 1 million | 9,216,267 | 48.13 [44.80–51.47] | 1624 | 43.19 [32.59–53.79] | 0.653 [0.431–0.989] | 0.0443 | 0.70 [0.64–0.77] | <.0001 |
Micropolitan | 1,736,350 | 9.07 [8.20–9.94] | 139 | 3.69 [1.48–5.91] | 0.296 [0.154–0.572] | 0.0003 | 0.27 [0.21–0.35] | <.0001 |
Not metropolitan or micropolitan | 1,041,038 | 5.44 [4.92–5.95] | 67 | 1.79 [0.73–2.86] | 0.240 [0.127–0.454] | <.0001 | 0.25 [0.18–0.34] | <.0001 |
Region | ||||||||
Northeast | 4,281,720 | 18.59 [15.96–21.23] | 814 | 18.87 [7.69–30.04] | Reference | – | Reference | – |
Midwest | 4,853,593 | 21.08 [17.99–24.16] | 883 | 20.45 [10.90–29.99] | 0.956 [0.463–1.976] | 0.9035 | 0.82 [0.71–0.94] | 0.0047 |
South | 8,992,204 | 39.05 [35.41–42.69] | 1450 | 33.59 [21.57–45.61] | 0.848 [0.421–1.708] | 0.6441 | 0.83 [0.74–0.94] | 0.0020 |
West | 4,901,051 | 21.28 [18.32–24.25] | 1170 | 27.10 [15.36–38.84] | 1.255 [0.599–2.632] | 0.5470 | 1.23 [1.11–1.36] | <.0001 |
Reasons for secondary admission
Rank | ICD-9-CM Code | Primary diagnosis | Weighted Frequency | Prevalence [95% CI] |
---|---|---|---|---|
Secondary diagnosis of JDM | ||||
1 | 6826 | Cellulitis of Leg | 101.62064 | 4.38%[3.46–5.30] |
2 | 6823 | Cellulitis of Arm | 97.86453 | 4.22%[3.31–5.12] |
3 | 486 | Pneumonia | 84.98956 | 3.66%[2.81–4.51] |
4 | V5789 | Rehabilitation procedure NEC | 84.56049 | 3.64%[2.77–4.51] |
5 | 88 | Other arthropod-borne disease | 52.25267 | 2.25%[1.58–2.93] |
No diagnosis of dermatomyositis | ||||
1 | 486 | Pneumonia | 1,206,317 | 5.24%[5.23–5.25] |
2 | 46,611 | Acute Bronchiolitis Due to RSV | 768,637 | 3.34%[3.33–3.35] |
3 | 49,392 | Asthma, unspecified, with exacerbation | 700,180 | 3.04%[3.03–3.05] |
4 | 46,619 | Acute Bronchiolitis Due to Other Infectious Organism | 561,443 | 2.44%[2.43–2.45] |
5 | 5409 | Acute appendicitis w/o mention of peritonitis | 550,923 | 2.39%[2.39–2.40] |
Rank | ICD-9-CM Codea | Diagnosis | Weighted Frequency | Row Prevalence [95% CI] |
---|---|---|---|---|
710.3 as Secondary Diagnosis | ||||
1 | 782.1 | Rash | 44 | 1.87 [0.65–3.10] |
2 | 728.87 | Muscle Weakness | 40 | 1.72 [0.39–3.05] |
3 | 729.1 | Muscle Pain | 30 | 1.30 [0.33–2.28] |
4 | 780.6 | Fever | 96 | 4.14 [2.26–6.01] |
5 | 787.20 | Dysphagia | 45 | 1.94 [0.43–3.46] |
6 | 784.42 | Dysphonia | 0 | – |
7 | 789.00 | Abdominal Pain | 23 | 0.97 [0.11–1.83] |
8 | CCS 204 | Arthritis NOS | 80 | 3.44 [1.86–5.02] |
9 | 709.3 | Calcinosis | 27 | 1.14 [0.06–2.23] |
10 | 578.1 | Melena | 8 | 0.36 [0.00–0.86] |
11 | 783.0 | Anorexia | 10 | 0.43 [0.00–1.04] |
No Diagnosis of 710.3 | ||||
1 | 782.1 | Rash | 166,932 | 0.73 [0.68–0.77] |
2 | 728.87 | Muscle Weakness | 8152 | 0.04 [0.03–0.04] |
3 | 729.1 | Muscle Pain | 31,879 | 0.14 [0.13–0.15] |
4 | 780.6 | Fever | 621,463 | 2.70 [2.53–2.87] |
5 | 787.20 | Dysphagia | 64,240 | 0.28 [0.23–0.32] |
6 | 784.42 | Dysphonia | 1836 | 0.01 [0.00–0.01] |
7 | 789.00 | Abdominal Pain | 159,317 | 0.69 [0.65–0.73] |
8 | CCS 204 | Arthritis NOS | 136,958 | 0.59 [0.56–0.63] |
9 | 709.3 | Calcinosis | 1025 | 0.0044 [0.0036–0.0053] |
10 | 578.1 | Melena | 59,509 | 0.26 [0.24–0.28] |
11 | 783.0 | Anorexia | 67,501 | 0.29 [0.25–0.33] |
Length of stay
Length of Stay | Cost of Care | |||||
---|---|---|---|---|---|---|
LSM | Adj Beta [95% CI]a | p-value | LSM | Adj Beta [95% CI]* | p-value | |
Age | ||||||
0–5 | 1.72 | 0 [ref] | – | 9.47 | 0 [ref] | – |
6–10 | 1.51 | −0.22[− 0.34--0.09] | 0.001 | 9.43 | − 0.03[− 0.24–0.17] | 0.7459 |
11–17 | 1.69 | − 0.04[− 0.19–0.12] | 0.6417 | 9.64 | 0.18[− 0.07–0.42] | 0.1536 |
Season | ||||||
Fall | 1.62 | −0.05[− 0.16–0.06] | 0.3442 | 9.57 | 0.00[− 0.24–0.23] | 0.9674 |
Winter | 1.67 | 0 [ref] | – | 9.57 | 0 [ref] | – |
Spring | 1.6 | −0.07[− 0.15–0.01] | 0.0853 | 9.45 | − 0.13[− 0.35–0.09] | 0.2514 |
Summer | 1.66 | − 0.01[− 0.11–0.08] | 0.7552 | 9.46 | − 0.11[− 0.33–0.10] | 0.3131 |
Gender | ||||||
Female | 1.64 | 0.01[− 0.09–0.11] | 0.8992 | 9.54 | 0.05[− 0.13–0.23] | 0.5914 |
Male | 1.63 | 0 [ref] | – | 9.49 | 0 [ref] | – |
Race | ||||||
White | 1.38 | 0 [ref] | – | 9.32 | 0 [ref] | – |
Black | 1.55 | 0.17[− 0.12–0.46] | 0.2395 | 9.44 | 0.12[− 0.21–0.45] | 0.4806 |
Hispanic | 1.66 | 0.28 [0.14–0.41] | <.0001 | 9.62 | 0.30 [0.05–0.55] | 0.0168 |
Other | 1.96 | 0.59 [0.31–0.86] | <.0001 | 9.68 | 0.36[−0.07–0.79] | 0.0993 |
Insurance | ||||||
Medicaid | 1.62 | 0.16 [0.01–0.31] | 0.0386 | 9.32 | 0.02[−0.21–0.25] | 0.8646 |
Private insurance | 1.46 | 0 [ref] | – | 9.3 | 0 [ref] | – |
Self-pay | 1.7 | 0.24[−0.07–0.55] | 0.1316 | 9.52 | 0.22[−0.67–1.10] | 0.6276 |
No charge | 2.11 | 0.65[−0.06–1.37] | 0.0739 | 10.48 | 1.18[−0.56–2.93] | 0.1833 |
Non-Medicaid government program | 1.3 | −0.16[− 0.29--0.04] | 0.0085 | 8.95 | −0.34[− 0.63--0.06] | 0.0196 |
Number of Chronic Conditions | ||||||
0–1 | 1.19 | 0 [ref] | – | 9.06 | 0 [ref] | – |
2 to 5 | 1.59 | 0.41 [0.29–0.52] | <.0001 | 9.42 | 0.36 [0.17–0.55] | 0.0002 |
6+ | 2.13 | 0.94 [0.63–1.26] | <.0001 | 10.07 | 1.01 [0.39–1.63] | 0.0014 |
Hospital Location | ||||||
Metropolitan >1million | 1.46 | 0 [ref] | – | 9.52 | 0 [ref] | – |
Fringe/Metro < 1 million | 1.41 | −0.04[−0.14–0.05] | 0.3704 | 9.35 | −0.17[− 0.36–0.02] | 0.0835 |
Micropolitan | 2.04 | 0.59 [0.27–0.90] | 0.0003 | 9.87 | 0.35[−0.20–0.91] | 0.2128 |
Not metropolitan or micropolitan | 1.64 | 0.19[−0.69–1.07] | 0.6753 | 9.31 | −0.20[− 0.98–0.58] | 0.6082 |
Region | ||||||
Northeast | 1.62 | 0 [ref] | – | 9.35 | 0 [ref] | – |
Midwest | 1.51 | −0.10[−0.29–0.09] | 0.285 | 9.63 | 0.28[−0.04–0.59] | 0.0875 |
South | 1.95 | 0.34 [0.12–0.56] | 0.0024 | 9.63 | 0.28 [0.00–0.56] | 0.0529 |
West | 1.47 | −0.15[−0.35–0.05] | 0.1342 | 9.44 | 0.09[−0.17–0.35] | 0.5113 |
Year | ||||||
2002–2003 | 1.79 | 0 [ref] | – | 9.55 | 0 [ref] | – |
2004–2005 | 1.64 | −0.15[−0.31–0.02] | 0.0785 | 9.44 | −0.11[− 0.44–0.23] | 0.5253 |
2006–2007 | 1.53 | −0.26[− 0.47--0.05] | 0.0146 | 9.34 | − 0.21[− 0.57–0.15] | 0.2445 |
2008–2009 | 1.73 | −0.06[− 0.24–0.11] | 0.4759 | 9.61 | 0.06[− 0.29–0.40] | 0.7548 |
2010–2011 | 1.51 | − 0.18[− 0.49–0.14] | 0.2666 | 9.39 | −0.16[− 0.52–0.20] | 0.3796 |
2012 | 1.61 | −0.28[− 0.43--0.13] | 0.0003 | 9.75 | 0.20[− 0.14–0.54] | 0.2469 |