Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services
Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services
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DOI：
10.1002/art.11200
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发表时间：
2003-08-15
期刊：
影响因子：
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通讯作者：
Van den Bos, GAM
中科院分区：
文献类型：
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作者：
Jacobi, CE;Mol, GD;Van den Bos, GAM
目标。量化类风湿关节炎患者社会经济地位（SES）对1)与病程相关的健康结局和相关医疗保健利用的影响，以及2)2年期间健康结局和相关医疗保健利用的变化。对878例类风湿关节炎（RA）患者进行问卷调查，患者病程从0年到15年以上不等。为了确定SES对健康结局和医疗保健使用的影响，在3个疾病病程组内和组间比较患者。此外，健康结果和医疗保健使用的纵向变化通过2年后发出的随访问卷进行评估。低SES患者的疾病活动性、身体健康、心理健康和生活质量都比高SES患者差。然而，这些差异随着时间的推移而减少。关于医疗保健的使用，我们发现低社会经济地位的患者比高社会经济地位的患者更少地使用联合医疗保健。应在卫生保健方面作出努力，以减轻社会经济地位较低的RA患者的健康劣势。特别是，可以改善获得联合保健的机会。
Objective. To quantify the impact of socioeconomic status (SES) among patients with rheumatoid arthritis on 1) health outcomes and related health care utilization in relation to disease duration and 2) changes in health outcomes and related health care utilization over a 2-year period.Methods. A questionnaire survey was conducted among 878 patients with rheumatoid arthritis (RA), varying in disease duration from 0 to more than 15 years. To determine the impact of SES on the health outcomes and health care use, patients were compared within and between 3 disease duration groups. Additionally, longitudinal changes in health outcomes and health care use were assessed with a followup questionnaire sent out 2 years later.Results. Patients with low SES have worse disease activity, physical health, mental health, and quality of life than patients with high SES. These differences, however, decreased over time. Regarding health care use, we found that patients with low SES made considerably less use of allied health care than patients with high SES.Conclusion. Efforts should be undertaken in health care to alleviate the health disadvantages of RA patients in lower socioeconomic groups. In particular, the access to allied health care could be improved.