Because Drs. Katz and Yelin are Editors of Arthritis Care & Research, review of this article was handled by the Editor of Arthritis & Rheumatism.
Systemic Lupus Erythematosus
Role of community and individual characteristics in physician visits for persons with systemic lupus erythematosus
Article first published online: 9 FEB 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 6, pages 888–895, June 2010
How to Cite
Tonner, C., Trupin, L., Yazdany, J., Criswell, L., Katz, P. and Yelin, E. (2010), Role of community and individual characteristics in physician visits for persons with systemic lupus erythematosus. Arthritis Care Res, 62: 888–895. doi: 10.1002/acr.20125
- Issue published online: 28 MAY 2010
- Article first published online: 9 FEB 2010
- Accepted manuscript online: 9 FEB 2010 12:00AM EST
- Manuscript Accepted: 26 JAN 2010
- Manuscript Received: 18 SEP 2009
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Numbers: 5R01AR56476, P60-AR0-53308
- Agency for Healthcare Research and Quality/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: 1-R01-HS0-13893
- Arthritis Foundation
- State of California Lupus Fund
To examine the effects of individual and local level socioeconomic status (SES) and health care access characteristics on the number of self-report physician visits for systemic lupus erythematosus (SLE).
Data derived from 755 adult participants from the 2004 to 2007 Lupus Outcomes Study (LOS) resulted in a sample of 2,926 repeated-measures observations. The outcome measure was the number of physician visits in the prior 12 months. Information on disease activity and manifestations, demographics, health insurance, and specialty of the participants' main SLE physician was collected through yearly LOS interviews. Local area measures including neighborhood poverty, the number of subspecialists per capita, and hospital market areas were added from secondary data sources. We used a mixed model with repeated measures to estimate the number of physician visits for SLE by SES and health care access characteristics, as well as the extent of concentrated poverty and number of subspecialists per capita in the local community, and whether these relationships varied by specific hospital market area. Multivariate models were adjusted for demographic and health status covariates.
LOS respondents reported a mean ± SD of 11.8 ± 10.7 (range 0–52) physician visits for SLE. After adjustment, having less than a high school education, receiving care in a health maintenance organization, being treated by a generalist, and living in a community of concentrated poverty were associated with a significantly lower number of physician visits for SLE. These relationships varied by hospital market areas.
Beyond health status, the number of physician visits for SLE varies by SES, neighborhood poverty, and characteristics of the health care system.