Qi Cynthia, Narayanaswami Pushpa, Anderson Ashley E L, Gelinas Deborah, Li Yuebing, Guptill Jeffrey T, Amirthaganesan Dakshinamoorthy, Ward Charlotte, Panchal Rupesh, Goyal Amit, Phillips Glenn
Argenx US Inc., Boston, MA, United States.
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Front Public Health. 2025 Feb 3;13:1448803. doi: 10.3389/fpubh.2025.1448803. eCollection 2025.
In myasthenia gravis (MG), evidence on the impact of social determinants of health on disparities in disease burden and healthcare resource utilization is limited. This study aimed to investigate the independent association between race/ethnicity and acute care utilization during the 2 years post-diagnosis among patients with MG.
A retrospective cohort study was conducted among adults (≥18 years) with newly diagnosed MG in the United States using Optum's de-identified Market Clarity Data from January 1, 2010, to December 31, 2019. Multivariable regression models were used to assess the association between acute care utilization and race/ethnicity, insurance, exacerbation at index, and other covariates.
A total of 7,058 patients met the study inclusion criteria, of whom 57% ( = 4,052) identified as Caucasian, 6% ( = 445) African American, 3% ( = 235) Hispanic, 1% ( = 94) Asian, and 32% ( = 2,232) with missing race/ethnicity information. Compared with patients identifying as Caucasian, those identifying as African American had 37% higher odds of having an emergency department visit in year 1, and those identifying as Hispanic had 70% increase in odds of having a hospitalization event in year 2 post-diagnosis. Among other covariates, Medicaid usage, exacerbation at index, and number of outpatient visits were significantly associated with acute care utilization.
Racial disparities significantly impacted acute care utilization in the first 2 years post-MG diagnosis. Future studies should aim to examine specific factors that may contribute to disparities such as barriers to healthcare access, greater severity of MG symptoms, and poorly controlled disease.
在重症肌无力(MG)中,关于健康的社会决定因素对疾病负担差异和医疗资源利用影响的证据有限。本研究旨在调查MG患者诊断后2年内种族/民族与急性护理利用之间的独立关联。
使用Optum从2010年1月1日至2019年12月31日去识别的市场清晰度数据,对美国新诊断为MG的成年人(≥18岁)进行了一项回顾性队列研究。多变量回归模型用于评估急性护理利用与种族/民族、保险、首次发病时病情加重以及其他协变量之间的关联。
共有7058名患者符合研究纳入标准,其中57%(n = 4052)为白种人,6%(n = 445)为非裔美国人,3%(n = 235)为西班牙裔,1%(n = 94)为亚洲人,32%(n = 2232)种族/民族信息缺失。与白种人患者相比,非裔美国人在诊断后第1年急诊就诊的几率高37%,西班牙裔在诊断后第2年住院的几率增加70%。在其他协变量中,医疗补助的使用、首次发病时病情加重以及门诊就诊次数与急性护理利用显著相关。
种族差异在MG诊断后的前2年对急性护理利用有显著影响。未来的研究应旨在检查可能导致差异的具体因素,如医疗保健获取障碍、MG症状更严重以及疾病控制不佳。