Objectives Irreversible tissue damage is frequently present at the time of diagnosis in systemic sclerosis (SSc), which calls for earlier diagnosis. This study estimated healthcare utilization three years before the diagnosis of SSc. Methods We conducted a population-based cohort study using data from Danish national registries. Incident patients diagnosed with SSc between January 1, 2005, and December 31, 2018, were matched by age and gender with 10 references without SSc. The date of diagnosis was the index date. We estimated quarterly rates and adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CI) of healthcare utilization in the three years preceding the diagnosis for patients with SSc and their references. Results A total of 1,650 SSc patients (1,255 women and 395 men) and 16 500 non-SSc references were included. The mean age was 58 years (interquartile range 48–68). Three years before diagnosis, patients with SSc had more contacts with general practice (IRRwomen= 1.43 [95% CI: 1.33; 1.53], IRRmen= 1.47 [95% CI: 1.26; 1.71]) and hospitals (IRRwomen= 1.86 [95% CI: 1.62; 2.14], IRRmen= 2.70 [95% CI: 2.04; 3.58]) compared with their references. In the last three months before diagnosis, patients with SSc had significantly more contacts with general practice (IRRwomen= 2.30 [95% CI: 2.16; 2.44], IRRmen= 2.98 [95% CI: 2.64; 3.35]) and hospitals (IRRwomen= 5.62 [95% CI: 5.08; 6.20], IRRmen= 9.53 [95% CI: 7.81; 11.63]). Conclusion The higher use of healthcare services in general practice and hospitals in the three years before diagnosis suggests an opportunity to facilitate earlier diagnosis and treatment of SSc.

中文翻译：

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诊断为系统性硬化症之前全科医学和医院的医疗保健利用：一项全国性的注册研究


目的 系统性硬化症 （SSc） 在诊断时经常存在不可逆的组织损伤，这需要早期诊断。本研究估计了 SSc 诊断前三年的医疗保健利用率。方法 我们使用来自丹麦国家登记处的数据进行了一项基于人群的队列研究。2005 年 1 月 1 日至 2018 年 12 月 31 日期间诊断为 SSc 的新发患者按年龄和性别匹配 10 例无 SSc 的参考文献。诊断日期是索引日期。我们估计了 SSc 患者及其参考文献在诊断前三年内医疗保健利用的季度比率和调整后的发病率比 （IRR） 以及 95% 置信区间 （CI）。结果 共纳入 1,650 例 SSc 患者 （1,255 例女性和 395 例男性） 和 16 500 例非 SSc 参考文献。平均年龄为 58 岁 （四分位距 48-68）。诊断前 3 年，SSc 患者与全科诊所 （IRRwomen= 1.43 [95% CI： 1.33;1.53]， IRRmen= 1.47 [95% CI： 1.26;1.71]）和医院 （IRRwomen= 1.86 [95% CI： 1.62;2.14]， IRRmen= 2.70 [95% CI： 2.04;3.58]）的接触更多。在诊断前的最后三个月，SSc 患者与全科诊所 （IRRwomen= 2.30 [95% CI： 2.16;2.44]，IRRmen= 2.98 [95% CI： 2.64;3.35]）和医院 （IRRwomen= 5.62 [95% CI： 5.08;6.20]，IRRmen= 9.53 [95% CI： 7.81;11.63]）的接触明显增加。结论 诊断前 3 年内全科医学和医院医疗保健服务的使用率较高，这表明有机会促进 SSc 的早期诊断和治疗。