Because Drs. Yelin and Katz are Editors of Arthritis Care & Research, review of this article was handled by the Editor of Arthritis & Rhehumatism.
Medicaid and access to care among persons with systemic lupus erythematosus
Version of Record online: 30 APR 2007
Copyright © 2007 by the American College of Rheumatology
Arthritis Care & Research
Volume 57, Issue 4, pages 601–607, 15 May 2007
How to Cite
Gillis, J. Z., Yazdany, J., Trupin, L., Julian, L., Panopalis, P., Criswell, L. A., Katz, P. and Yelin, E. (2007), Medicaid and access to care among persons with systemic lupus erythematosus. Arthritis & Rheumatism, 57: 601–607. doi: 10.1002/art.22671
- Issue online: 30 APR 2007
- Version of Record online: 30 APR 2007
- Manuscript Accepted: 30 NOV 2006
- Manuscript Received: 16 AUG 2006
- Arthritis Foundation's State of California Lupus Fund
- Rosalind Russell Medical Research Center for Arthritis
- US Public Health Service's National Center for Research Resources. Grant Number: 5-M01-RR-00079
- Agency for Healthcare Research and Quality/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: 1-R01-HS-013893
- NIH. Grant Numbers: K24-AR-02175, R01-AR-44804
- Access to care;
To evaluate the associations between Medicaid insurance and distance traveled by patients to treating physicians and health care utilization for patients with systemic lupus erythematosus (SLE).
A total of 982 adults with SLE were recruited between 2002 and 2004. We calculated the distance between patient homes and physicians using Mapquest, an Internet mapping program. We then assessed the association between Medicaid status and distance traveled to the primary SLE provider, presence of ≥1 physician visits, and the number of all physician visits, with and without adjustment for demographic and medical covariates.
On an unadjusted basis, Medicaid patients traveled longer distances to see their primary SLE provider. This effect was pronounced for patients under the care of a rheumatologist. Adjustment reduced, but did not eliminate, these differences. With adjustment for covariates, Medicaid patients were equally as likely to see a rheumatologist as non-Medicaid patients. However, Medicaid patients were more likely to be seen by a general practitioner or in the emergency room for their SLE, and reported more visits to general practitioners and the emergency room for SLE.
Medicaid patients with SLE traveled longer distances to see an SLE physician, especially rheumatologists. They also reported a different pattern of health care utilization. These results suggest that Medicaid patients may face barriers in obtaining comprehensive medical services in proximity to their residences.