Area-level socioeconomic status impacts healthcare visit frequency by Australian inflammatory arthritis patients: results from the Australian Rheumatology Association Database

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dc.contributor.authorRussell, O.
dc.contributor.authorLester, S.
dc.contributor.authorBlack, R.J.
dc.contributor.authorLassere, M.
dc.contributor.authorBarrett, C.
dc.contributor.authorMarch, L.
dc.contributor.authorLynch, T.
dc.contributor.authorBuchbinder, R.
dc.contributor.authorHill, C.L.
dc.date.issued2025
dc.description.abstractObjective: Individuals with inflammatory arthritis require long-term rheumatologist care for optimal outcomes. We sought to determine if socioeconomic status (SES) influences general practitioner (GP) and specialist physician visit frequency and out-of-pocket (OOP) visit costs. Methods: We linked data from Australian Rheumatology Association Database (ARAD) participants with rheumatoid arthritis or psoriatic arthritis to the Pharmaceutical Benefits (PBS) and M edicare Benefits Schedule from 2011 to 2018. Small-area SES was approximated as quintiles of the Index of Relative Socioeconomic Advantage and Disadvantage. A comorbidity index (Rx-Risk) was determined from PBS data. Analysis was performed using panel regression methods. Results: We included 1,916 ARAD participants (76.3% rheumatoid arthritis, 71.1% women, mean ± SD age 54 ± 12 years and disease duration 6 ± 4 years). Participants averaged 9.0 (95% confidence interval [CI] 8.6–9.4) annual GP visits and 3.9 (95% CI 3.8–4.1) annual specialist physician visits. After adjustment for sex, age, education, remoteness, and comorbidity, there was an inverse relationship between annual GP visit frequency and higher SES quintile (–0.6, 95% CI –0.9 to –0.3 visits per quintile) and a direct relationship between more frequent specialist visits and higher SES (linear slope 0.3, 95% CI 0.2–0.5 visits per quintile). Average OOP costs/visit were higher for specialist physician (AUD$38.43; 95% CI 37.34–39.53) versus GP visits (AUD$7.86; 95% CI 7.42–8.31), and higher SES was associated with greater OOP cost. Conclusion: Patients with higher SES have relatively fewer GP visits and more specialist physician visits compared with patients with lower SES, suggesting individuals with lower SES may receive suboptimal specialist physician care. OOP costs may be a contributing factor.
dc.description.statementofresponsibilityOscar Russell, Susan Lester, Rachel J. Black, Marissa Lassere, Claire Barrett, Lyn March, Tom Lynch, Rachelle Buchbinder, and Catherine L. Hill
dc.identifier.citationArthritis Care and Research, 2025; 77(1):127-135
dc.identifier.doi10.1002/acr.25456
dc.identifier.issn2151-464X
dc.identifier.issn2151-4658
dc.identifier.orcidRussell, O. [0000-0002-7134-6362]
dc.identifier.orcidLester, S. [0000-0003-3013-2701]
dc.identifier.orcidBlack, R.J. [0000-0001-6600-7430]
dc.identifier.orcidHill, C.L. [0000-0001-8289-4922]
dc.identifier.urihttps://hdl.handle.net/2440/147940
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1194483
dc.rights© 2024 American College of Rheumatology
dc.source.urihttps://doi.org/10.1002/acr.25456
dc.subjectSocioeconomic Status Impacts Health Care Visit Frequency; Inflammatory Arthritis; Australia
dc.subject.meshHumans
dc.subject.meshArthritis, Psoriatic
dc.subject.meshArthritis, Rheumatoid
dc.subject.meshRheumatology
dc.subject.meshSocial Class
dc.subject.meshDatabases, Factual
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshMiddle Aged
dc.subject.meshHealth Expenditures
dc.subject.meshOffice Visits
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshRheumatologists
dc.titleArea-level socioeconomic status impacts healthcare visit frequency by Australian inflammatory arthritis patients: results from the Australian Rheumatology Association Database
dc.typeJournal article
pubs.publication-statusPublished online

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