Ethnicity and access to care in systemic lupus erythematosus

Objective. To define access to care and to examine the relationship between ethnicity and access to care in systemic lupus erythematosus (SLE). Methods. A review of published literature was supplemented with preliminary data from a piler study. Data from patient interviews, chart reviews, and insurer surveys were collected at 2 sites and used to develop several measures of access. The relationship between ethnicity and access was examined through chi-square analyses, difference of means testing, and multivariate regression. Results. Although African-American SLE patients appear less likely to be privately insured and more likely to be uninsured, no significant differences in utilization rates were detected between ethnic groups. Uninsured patients, however, had significantly fewer physician visits than both the Medicaid and the privately insured patients. Multivariate regression results confirm a strong and negative relationship between physician visits and patient coinsurance rates. Conclusion. Careful examination of multiple dimensions of access may highlight differences between ethnic groups. Further research is necessary to document these differences and explore their relationships to outcomes.