SOCIAL/CLINICAL CHARACTERISTICS OF SARCOIDOSIS PATIENTS

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Sarcoidosis is a chronic inflammatory granulomatous disease of unknown cause which is more prevalent among young adults, particularly women, and occurs more frequently, and perhaps more severely, in Blacks. Blacks are likely to be of lower socioeconomic status, uninsured or underinsured, to use less health services, and more likely to receive Medicaid and other forms of Public Assistance, all of which could affect medical service use and outcomes of care for sarcoidosis. Currently a Sarcoidosis Registry is being developed for the Metropolitan Washington, D.C., Area, consisting of data abstracted from sarcoidosis patients clinic records from two related University hospitals in D.C. The intent of this project is to enhance this registry to permit further standardized description of existing and new sarcoidosis patients and testing of presumptive hypotheses on relationships among race, SES, compliance, disease severity, and insurance status and health services use. We propose to expand, maintain and analyze the registry data to develop a sarcoidosis disease cohort of patients seen in the primary and secondary services of a single University Medical Center located in Washington, D.C., an area with a large Black population. Registry data will consist of standardized medical record abstracts of patients seen since July 1, 1992. Abstract data include: sociodemographic status; economic and employment status; family sarcoidosis history; presence of other diseases; current symptoms; laboratory and x-ray tests; medication use; and smoking and illicit drug use. Additionally, a telephone survey will be used to obtain additional standardized information on all registry patients. The survey content will consist of reported disease symptoms; quality of life (QOL); medical care use and compliance; insurance, public assistance and welfare status; income; and physical and social functioning. We will analyze the estimated 200-patient registry cases by race and socioeconomic status using abstract and survey patient descriptors, and test presumptive hypotheses on the relationship of race and socioeconomic status to disease status at presentation and over time, quality of life, physical and social functioning, medical care use, compliance with care, and medical insurance coverage and welfare.