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Krati Chauhan, Steven Scaife, James T. Rosenbaum; Health disparities impact prevalence and complications of noninfectious uveitis: results from the National Inpatient Sample. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1137.
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Prevalence and severity of autoimmune disease like systemic lupus erythematous are influenced by health disparities which include race, income, sex and age. However, there is a lack of national data regarding effect of these factors on complications and prevalence of noninfectious uveitis (NIU).The primary aim of our study is to examine the influence of income and race for prevalence of NIU and its complications. We performed a retrospective, observational, and cross-sectional study using the National Inpatient Sample (NIS) for the years 2002-2013.
The NIS is a de-identified sample of U.S. community hospitals. We used the (ICD-9) codes to identify NIU cases and ocular complications. We collected information on age, sex, race, income quartile (< $ 38,999, $ 39,000-$ 47,999, $ 48,000-$ 62,999 and > $ 63,000), insurance status and ocular complications. Statistical analysis was done using SAS version 9.4. We performed multivariate logistic regression analysis, using age, sex, race, income quartile and payer status as predictor variables, to obtain adjusted odds ratio for developing NIU and its complications. To assess the effect of income, irrespective of race on developing NIU and its complications, we performed logistic regression analysis excluding African Americans, using income and Medicaid as predictor variables
There were a total of 94,143,978, discharges from 2002-2013, out of these 15,296 had NIU. After adjusting for age, race, sex, payer status, income quartile, odds of African Americans(AA) having NIU are double as compared to Caucasians (OR=2.16, 95% CI:2.07-2.26), and odds of AA developing ocular complications such as blindness, legal blindness, retinal edema, retinal ischemia and glaucoma, are 1.5 times as compared to Caucasians (OR=1.44, 95% CI=1.16-1.79). Odds of Medicare (OR=2.18, 95% CI=1.67-2.84) and Medicaid (OR=2.11, 95% CI=1.59-2.81) patients having complications from NIU are double as compared to those with private insurance. After excluding African Americans, Medicaid patients have 13% greater odds (OR=1.13, 95% CI= of having NIU and 28% greater odds (OR=1.28, 95% CI=1.01-1.6) of having ocular complications from NIU.
Income and race influence prevalence and complications from NIU. African Americans and poor patients have higher prevalence NIU and its complications
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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