Medicaid and access to care among persons with systemic lupus erythematosus
Open Access
- 30 April 2007
- journal article
- research article
- Published by Wiley in Arthritis Care & Research
- Vol. 57 (4), 601-607
- https://doi.org/10.1002/art.22671
Abstract
Objective To evaluate the associations between Medicaid insurance and distance traveled by patients to treating physicians and health care utilization for patients with systemic lupus erythematosus (SLE). Methods A total of 982 adults with SLE were recruited between 2002 and 2004. We calculated the distance between patient homes and physicians using Mapquest, an Internet mapping program. We then assessed the association between Medicaid status and distance traveled to the primary SLE provider, presence of ≥1 physician visits, and the number of all physician visits, with and without adjustment for demographic and medical covariates. Results On an unadjusted basis, Medicaid patients traveled longer distances to see their primary SLE provider. This effect was pronounced for patients under the care of a rheumatologist. Adjustment reduced, but did not eliminate, these differences. With adjustment for covariates, Medicaid patients were equally as likely to see a rheumatologist as non‐Medicaid patients. However, Medicaid patients were more likely to be seen by a general practitioner or in the emergency room for their SLE, and reported more visits to general practitioners and the emergency room for SLE. Conclusion Medicaid patients with SLE traveled longer distances to see an SLE physician, especially rheumatologists. They also reported a different pattern of health care utilization. These results suggest that Medicaid patients may face barriers in obtaining comprehensive medical services in proximity to their residences.Keywords
This publication has 18 references indexed in Scilit:
- Association of socioeconomic and demographic factors with utilization of rheumatology subspecialty care in systemic lupus erythematosusArthritis Care & Research, 2007
- Work dynamics among persons with systemic lupus erythematosusArthritis Care & Research, 2007
- Access to Orthopaedic Care for Children With Medicaid Versus Private InsuranceJournal of Pediatric Orthopaedics, 2006
- Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England VeteransThe Journal of Rural Health, 2005
- Inequality of Access to Surgical Specialty Health Care: Why Children With Government-Funded Insurance Have Less Access Than Those With Private Insurance in Southern CaliforniaPEDIATRICS, 2004
- Utilization of low‐volume hospitals for total hip replacementArthritis Care & Research, 2004
- Medicare, medicaid, and access to dermatologists: The effect of patient insurance on appointment access and wait timesJournal of the American Academy of Dermatology, 2004
- The Association of Race/Ethnicity With the Receipt of Traditional and Alternative Arthritis-Specific Health CareMedical Care, 2003
- Access to medical care among persons with musculoskeletal conditionsArthritis & Rheumatism, 1995
- Progression of Functional Disability in Patients With Rheumatoid ArthritisArchives of Internal Medicine, 1993