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Abstract：
OBJECTIVE: This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES).
METHODS: Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis.
RESULTS: Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use.
CONCLUSIONS: The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.
METHODS: Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis.
RESULTS: Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use.
CONCLUSIONS: The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.
摘要：
目的：本横断面研究旨在调查基于社会经济地位（SES）的类风湿性关节炎（RA）患者的生物制剂治疗差异。
方法：分析了来自KOrean关节炎观察研究网络（KORONA）数据库的数据，以评估与SES相关的各种因素，健康行为,和生物制品的使用。采用Logistic回归和结构化方程模型(SEM)进行数据分析。
结果：在5,077例RA患者中，393名（7.7％）患者被确定为生物制剂使用者。在整个队列中，31.8%的参与者是低收入和低教育群体,39.3%的参与者属于高收入和高等教育群体。尽管低收入或低教育的患者在诊断时经历了较高的疾病活动性，有更多的合并症，表现出更高的药物依从性，接受了更多的检查，入院人数比同行多，低收入人群患者接受生物制剂的几率降低了34%(校正后比值比=0.76,95%置信区间:0.60-0.96,p=0.021).SEM和途径分析证实了低SES对生物制品使用的负面影响。
结论：研究结果表明，SES在RA患者的生物制剂使用中起着重要作用，表明低SES患者的潜在医疗保健效率低下。此外，不良的医疗习惯会对RA患者的生物制剂使用产生负面影响。该研究强调了在讨论生物制剂使用和促进公平获取生物制剂以实现最佳RA管理的同时考虑社会经济因素的重要性。
方法：分析了来自KOrean关节炎观察研究网络（KORONA）数据库的数据，以评估与SES相关的各种因素，健康行为,和生物制品的使用。采用Logistic回归和结构化方程模型(SEM)进行数据分析。
结果：在5,077例RA患者中，393名（7.7％）患者被确定为生物制剂使用者。在整个队列中，31.8%的参与者是低收入和低教育群体,39.3%的参与者属于高收入和高等教育群体。尽管低收入或低教育的患者在诊断时经历了较高的疾病活动性，有更多的合并症，表现出更高的药物依从性，接受了更多的检查，入院人数比同行多，低收入人群患者接受生物制剂的几率降低了34%(校正后比值比=0.76,95%置信区间:0.60-0.96,p=0.021).SEM和途径分析证实了低SES对生物制品使用的负面影响。
结论：研究结果表明，SES在RA患者的生物制剂使用中起着重要作用，表明低SES患者的潜在医疗保健效率低下。此外，不良的医疗习惯会对RA患者的生物制剂使用产生负面影响。该研究强调了在讨论生物制剂使用和促进公平获取生物制剂以实现最佳RA管理的同时考虑社会经济因素的重要性。
