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Disparities among children with juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis (JRA), a group of autoimmune diseases involving chronic inflammation of the joints, can adversely affect health-related quality of life, often into adulthood. Studies in adults with arthritis suggest that socioeconomic status impacts patient prognosis, but no information is available as to whether this is also true in children. A study published in the June 2006 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined the relationship between patient health insurance coverage (as an indicator of socioeconomic status) and disease outcomes for children with JRA and found that those on Medicaid had significantly lower health-related quality of life (HRQOL) and higher disability.

Led by Hermine I. Brunner, Janalee Taylor and Murray Passo of the Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio, researchers assessed children with JRA who were seen at the hospital's rheumatology clinic between July 2003 and March 2004. Medicaid coverage (or similar coverage under state programs for low-income families of children with chronic diseases) was considered to be an indicator of low socioeconomic status, while having private insurance was considered to be an indicator of middle to high socioeconomic status. Children were evaluated based on age, disease duration, type of JRA onset, course of the disease, number of joints affected, current disease activity, pain, disability and HRQOL. Health care resource utilization was also assessed based on billing for events such as radiology testing, laboratory testing, clinic visits, and inpatient care.

The findings showed that there was a trend toward a higher number of joints affected by arthritis in the Medicaid group, which comprised 40 (14%) of the 295 children evaluated. They also had somewhat higher disease activity, more pain, and a lower level of well-being
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
26-May-2006


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