Medicaid and access to care among persons with systemic lupus erythematosus

Abstract

Objective. 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). Methods. 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. Results. 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. Conclusion. 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.

Health care usage in Dutch systemic lupus erythematosus patients

“…22 Also patients in our population reported contacts with a rheumatologist as often as found in the literature. 23 Concerning health professionals the patients in our population reported many more contacts than found in the literature, for instance in Canada patients had a mean of two visits per year. 22 No data on care at home or day patient care was available for comparison.…”

Predictive Value of Serum and Urinary Adiponectin in Systemic Lupus Erythematosus Activity and Lupus Nephritis

“…SLE targets multiple organ systems including joints, skin, kidneys, CNS and others organs 1,2 . Renal involvement is common in SLE affecting 50% adult subjects suffering from SLE 3 .…”

“…Systemic lupus erythematosus (SLE) is chronic autoimmune, multisystemic, relapsing, and remitting disease that is characterized by the production of autoantibodies directed against several antigens in multiple organs including joints, skin, serous membranes, kidneys, blood, central nervous system (CNS) and others organs 1,2 . Renal involvement is very common in SLE affecting 50% adult subjects suffering from SLE 3 .…”

Algorithm for the treatment of systemic lupus erythematosus. Current state of the problem

“…Разработка унифицированных подходов к терапии затруднена за счет различий больных СКВ, свя-занных с модифицируемыми и немодифицируемыми фак-торами риска, такими как социально-экономический ста-тус, раса и этническая принадлежность, уровень образова-ния, материального дохода и пр. Все вышеперечисленные компоненты представляют собой важные мишени воздей-ствия с целью совершенствования методов лечения забо-левания, ранее считавшегося фатальным [4,5].…”