Abstract
Abstract
Objectives
Persons with Rheumatoid Arthritis (RA) are at increased risk for ambulatory care sensitive conditions (ACSCs) hospitalisations. We assess if socioeconomic status (SES) modifies this association.
Methods
Individuals meeting a validated case definition for RA in a Canadian population-based administrative health dataset (years 2007-2023) were matched 1:4 by age and sex to general population controls. SES was determined using a combined material and social deprivation index derived from area-level census data and categorised into quintiles (Q1 privileged toQ5 deprived). Crude and adjusted incidence rate ratios (IRR) for ACSC admissions were estimated at 3- and 5- years following index date using zero-inflated Poisson regression models. Potential additive and multiplicative interactions were assessed.
Results
We identified 83,811 unique hospitalizations in 52,596 RA cases and 190,300 in 210,384 controls. ACSC-related admissions increased in frequency with greater levels of deprivation. RA cases with privilege had significantly higher rates of ACSC-related hospitalization compared with controls at 3 years (SES Q1: IRR 1.34, 95% CI 1.02–1.77; Q2: IRR 1.30, 95% CI 1.05–1.62) and 5 years (Q2: IRR 1.20, 95% CI 1.01–1.42)whereascases and controls with deprivation had similar incidence rates for ACSC admissions (3 years Q4: IRR 0.95, 95% CI 0.81–1.12; Q5: IRR 1.00, 95% CI 0.89–1.12; 5 years Q4: IRR 1.07, 95% CI 0.95–1.20; Q5: IRR 1.02, 95% CI 0.94–1.12). Interaction tests and Relative Excess Risk due to Interactions were non-significant.
Conclusion
Socioeconomic deprivation and RA case status independently elevate the risk of an ACSC hospitalization.