Jacobi Catharina E, Mol Geert D, Boshuizen Hendriek C, Rupp Ines, Dinant Huibert J, Van Den Bos Geertrudis A M
Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Arthritis Rheum. 2003 Aug 15;49(4):567-73. doi: 10.1002/art.11200.
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.
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.
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.
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.
量化类风湿性关节炎患者的社会经济地位（SES）对以下两方面的影响：1）与疾病持续时间相关的健康结局及相关医疗保健利用情况；2）两年期间健康结局及相关医疗保健利用情况的变化。
对878名类风湿性关节炎（RA）患者进行了问卷调查，疾病持续时间从0年到超过15年不等。为确定SES对健康结局和医疗保健使用的影响，在3个疾病持续时间组内和组间对患者进行了比较。此外，通过两年后发出的随访问卷评估了健康结局和医疗保健使用的纵向变化。
社会经济地位低的患者比社会经济地位高的患者疾病活动度、身体健康、心理健康和生活质量更差。然而，这些差异会随着时间推移而减小。在医疗保健使用方面，我们发现社会经济地位低的患者比社会经济地位高的患者使用联合医疗保健的情况要少得多。
医疗保健领域应努力减轻社会经济地位较低群体中类风湿性关节炎患者的健康劣势。特别是，可以改善联合医疗保健的可及性。
