Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Arch Dermatol Res. 2024 Aug 22;316(8):554. doi: 10.1007/s00403-024-03275-8.
Vitiligo is an autoimmune skin depigmenting disorder that can negatively impact quality of life. A new FDA approved treatment for vitiligo offers considerable promise, and to maximize benefits strategies to implementation should consider disease burden, healthcare access, and healthcare utilization of individuals with vitiligo. Using the All of Us Research Program's large data set, including survey responses, we investigated these outcomes among participants with and without vitiligo. Our analysis used quality of life, delayed care due to an obstacle, and seeing a doctor in the past year as dichotomized proxies for disease burden, healthcare access, and healthcare utilization. The results show that people with vitiligo are more likely to report worse quality of life but ostensibly greater healthcare access and utilization compared to people without vitiligo. However, these relationships are not significant when adjusted for demographics, socioeconomic characteristics, and comorbidities of vitiligo. Prior research has shown non-Caucasian individuals have worse health outcomes in general, and worse quality of life within the vitiligo population. Our data demonstrated consistent findings; moreover, we found that non-Caucasian individuals with vitiligo had inferior healthcare access and lower health care utilization than Caucasian individuals. Implementation of new treatments for vitiligo should prioritize disadvantaged individuals to improve health equity.
白癜风是一种自身免疫性皮肤色素脱失疾病，会对生活质量产生负面影响。一种新的美国食品和药物管理局批准的白癜风治疗方法带来了很大的希望，为了最大限度地发挥其益处，策略的实施应该考虑到白癜风患者的疾病负担、医疗保健的可及性和利用情况。利用 All of Us 研究计划的大型数据集，包括调查回复，我们调查了白癜风患者和非白癜风患者的这些结果。我们的分析使用生活质量、因障碍而延迟治疗以及过去一年看医生作为疾病负担、医疗保健可及性和医疗保健利用的二分代理。结果表明，与非白癜风患者相比，白癜风患者更有可能报告生活质量更差，但表面上看他们的医疗保健可及性和利用率更高。然而，当调整了白癜风的人口统计学、社会经济特征和合并症后，这些关系就不显著了。先前的研究表明，非白种人总体上的健康结果更差，白癜风患者的生活质量更差。我们的数据显示了一致的发现；此外，我们发现患有白癜风的非白种人比白种人获得医疗保健的机会更少，利用医疗保健的情况也更低。新的白癜风治疗方法的实施应该优先考虑弱势群体，以改善健康公平。
