{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:11:44Z","timestamp":1777929104205,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["F30MD015211"],"award-info":[{"award-number":["F30MD015211"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD010243"],"award-info":[{"award-number":["R01MD010243"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32 GM140935"],"award-info":[{"award-number":["T32 GM140935"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005902","name":"Institute for Clinical and Translational Research, University of Wisconsin, Madison","doi-asserted-by":"publisher","award":["1UL1TR002373"],"award-info":[{"award-number":["1UL1TR002373"]}],"id":[{"id":"10.13039\/100005902","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>While quality lupus care is associated with lower lupus-related damage, the impact of access and process quality measures on other lupus outcomes remains unclear. Given high acute care in young adults, our objective was to evaluate two process quality measures, visit-based retention in lupus care and receipt of lupus-specific serologic testing, and associations with subsequent acute care use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study used a 20% national sample of young adult (ages 18\u201335) Medicare beneficiaries with lupus to first measure visit-based retention in rheumatology care and receipt of \u22651 complement or dsDNA test over 1\u00a0year. Acute care use (Emergency Department visits and hospitalizations) was then assessed in the subsequent 6\u00a0months. Associations of visit-based retention and serologic testing with acute care were evaluated with Cox regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1036 young adults with lupus, acute care use was very high \u2013 nearly 60% at 6\u00a0months. Observed acute care-free survival time was longer in patients who had visit-based retention (154 vs 104 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02) or serologic testing (166 vs 101 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). Only 28% of beneficiaries had serologic testing, but this was associated with 21% lower incidence of acute care (aHR 0.79, 95% CI 0.65, 0.97) after adjustment; visit-based retention was not associated with acute care after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Receipt of complement or dsDNA antibody testing, a lupus-specific care quality indicator, was associated with reduced acute care use in young adults. Improving lupus care quality measures, like complement or dsDNA testing, may improve lupus outcomes including reduced acute care use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033251360289","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T08:46:33Z","timestamp":1752828393000},"page":"1013-1023","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of retention in care by visits or lupus-specific labs with acute care among young adults: A medicare cohort study"],"prefix":"10.1177","volume":"34","author":[{"given":"Maria","family":"Schletzbaum Bowler","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1828-0165","authenticated-orcid":false,"given":"Ang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Sociology, University of Wisconsin \u2013 Madison, Madison, WI, USA"},{"name":"Center for Demography and Ecology, University of Wisconsin \u2013 Madison, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad C","family":"Astor","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W Ryan","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7272-2692","authenticated-orcid":false,"given":"Shivani","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Gilmore-Bykovskyi","sequence":"additional","affiliation":[{"name":"Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"BerbeeWalsh Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kramer","sequence":"additional","affiliation":[{"name":"Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy J","family":"Kind","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6523-0374","authenticated-orcid":false,"given":"Christie M","family":"Bartels","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"},{"name":"Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203319896626"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2013-002494"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328323daad"},{"key":"e_1_3_6_5_2","unstructured":"Centers for Disease Control and Prevention. 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