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Older, Lower Income Patients Least Likely to See a Specialist for Lupus |
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From EurekAlert! - Breaking News: Despite advances in treatment, systemic lupus erythematosus (SLE) remains a serious disease. Other research has shown that care provided by specialists to patients with rheumatic diseases is associated with improved outcomes yet does not cost more. A new study published in the May 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) found older patients and those with lower incomes were less likely to see a specialist for SLE. Almost half of the participants reported a disease flare in the previous 3 months, and 22 percent reported no visits to a rheumatologist, although most of these had been seen by another type of physician. The results showed that patients 50 or older and those with lower incomes reported far fewer visits to a rheumatologist, and that male patients were less likely to see this type of specialist than female patients. The authors suggest that elderly individuals or those with lower incomes face barriers to accessing care that may include a lack of rheumatology services close by, a lack of awareness of this type of specialty, less frequent referrals to rheumatologists, or inadequate follow-up. "Subjects who were older than 50 years or in the lowest income category were twice as likely to report no rheumatology visits in the past year," the authors note. These findings are striking because the current study's patients were chosen from a pool of participants reenrolling from a previous UCSF SLE study who presumably had greater access to care than SLE patients in the general population. The authors point out that although elderly patients and those with lower incomes traditionally have access to health care through Medicare and Medicaid, the presence of health insurance alone did not ensure equal utilization of care.
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