Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services

Authors

  • Catharina E. Jacobi,

    Corresponding author
    1. Academic Medical Center, University of Amsterdam, Amsterdam, and National Institute of Public Health and the Environment, Bilthoven, The Netherlands
    • Academic Medical Center Amsterdam, Department of Social Medicine (J3), P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
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  • Geert D. Mol,

    1. National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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  • Hendriek C. Boshuizen,

    1. National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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  • Ines Rupp,

    1. Academic Medical Center, University of Amsterdam, Amsterdam, and National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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  • Huibert J. Dinant,

    1. Academic Medical Center, Jan van Breemen Institute, Amsterdam, and University of Amsterdam, Amsterdam, The Netherlands
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  • Geertrudis A. M. Van den Bos

    1. Academic Medical Center, University of Amsterdam, Amsterdam, and National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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Abstract

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.

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