Table 2.
Factors associated with glucocorticoid monotherapy use among Medicare beneficiaries with rheumatoid arthritis
| Unadjusted
|
Adjusted
|
|||
|---|---|---|---|---|
| Glucocorticoid monotherapy users, % (95% CI) | P* | Glucocorticoid monotherapy users, % (95% CI) | P† | |
| Overall glucocorticoid monotherapy use Sociodemographic characteristics |
10.2 (9.5–10.8) | 10.2 (9.5–10.8) | ||
| Age, years | < 0.0001 | < 0.0001 | ||
| 65–69 | 6.4 (5.3–7.5) | 6.7 (5.6–7.8) | ||
| 70–74 | 7.2 (6.1–8.2) | 7.9 (6.8–9.1) | ||
| 75–79 | 10.3 (8.9–11.7) | 10.6 (9.2–12.0) | ||
| 80–84 | 13.5 (11.7–15.3) | 12.5 (10.9–12.0) | ||
| ≥85 | 20.3 (17.6–23.0) | 16.3 (14.1–18.5) | ||
| Sex | 0.9122 | 0.2689 | ||
| Female | 10.2 (8.7–11.8) | 10.9 (9.4–12.5) | ||
| Male | 10.1 (9.4–10.5) | 10.0 (9.3–10.7) | ||
| Race/ethnicity | 0.0040 | 0.0925 | ||
| African American | 13.8 (11.2–16.4) | 10.9 (8.8–13.0) | ||
| Other | 9.4 (6.8–12.0) | 7.6 (5.5–9.8) | ||
| White | 9.8 (9.1–10.5) | 10.3 (9.6–11.0) | ||
| Comorbid illness | ||||
| Charlson comorbidity score | < 0.0001 | 0.0877 | ||
| 1 | 8.7 (8.0–9.5) | 9.8 (9.0–10.6) | ||
| 2 | 11.9 (10.3–13.4) | 10.1 (8.8–11.4) | ||
| ≥3 | 19.5 (16.4–22.6) | 11.9 (10.1–13.8) | ||
| Health care utilization | ||||
| Prescriptions originating from rheumatologist | < 0.0001 | < 0.0001 | ||
| None | 18.1 (16.6–19.6) | 13.2 (12.0–14.4) | ||
| ≥1 | 6.5 (5.8–7.1) | 8.0 (7.2–8.7) | ||
| Claims from rheumatologist | < 0.0001 | < 0.0001 | ||
| None | 20.9 (19.2–22.5) | 17.5 (16.0–19.0) | ||
| 1–4 | 7.6 (6.7–8.6) | 8.5 (7.4–9.5) | ||
| ≥5 | 3.3 (2.6–4.0) | 3.7 (2.9–4.4) | ||
| Annual physician office visits | 0.0026 | < 0.0050 | ||
| 0–8 | 10.5 (9.4–11.7) | 9.3 (8.3–10.4) | ||
| 9–15 | 8.6 (7.6–9.7) | 9.5 (8.4–10.6) | ||
| ≥16 | 11.4 (10.2–12.6) | 11.9 (10.6–13.2) | ||
| Annual hospitalizations | < 0.0001 | < 0.0001 | ||
| None | 8.6 (7.9–9.3) | 9.0 (8.3–9.7) | ||
| 1 | 13.2 (11.3–15.1) | 12.6 (10.9–14.4) | ||
| ≥2 | 19.5 (16.4–22.6) | 15.4 (12.8–19.0) | ||
| Socioeconomic status | ||||
| Area-level socioeconomic status‡ | 0.4710 | 0.4761 | ||
| Quintile 1 (lowest-income counties) | 9.8 (8.4–11.1) | 9.4 (8.0–10.8) | ||
| Quintile 2 | 9.6 (8.3–11.0) | 10.3 (8.9–11.6) | ||
| Quintile 3 | 9.9 (8.5–11.3) | 10.4 (9.0–11.7) | ||
| Quintile 4 | 11.4 (9.8–12.9) | 11.1 (9.6–12.6) | ||
| Quintile 5 (highest-income counties) | 10.3 (8.5–12.1) | 9.4 (7.7–11.2) | ||
| Personal income | < 0.0001 | 0.0002 | ||
| Not low | 9.0 (8.3–9.7) | 9.4 (8.6–10.1) | ||
| Enrolled in low-income subsidy program | 14.1 (12.5–15.7) | 12.3 (10.9–13.8) | ||
| Area-level physician supply | ||||
| Health professional shortage area | 0.2982 | 0.4264 | ||
| No shortage area | 11.0 (9.2–12.7) | 10.8 (9.0–12.6) | ||
| Shortage area | 10.0 (9.3–10.7) | 10.0 (9.3–10.8) | ||
| Census geographic divisions | < 0.0001 | < 0.0001 | ||
| New England | 10.9 (7.9–13.9) | 11.0 (8.1–14.0) | ||
| Mid-Atlantic | 15.0 (12.8–17.2) | 14.4 (12.3–16.5) | ||
| East North Central Midwest | 9.5 (12.8–17.2) | 10.4 (8.6–12.2) | ||
| West North Central Midwest | 8.1 (6.2–10.1) | 8.1 (6.2–9.9) | ||
| South Atlantic | 10.9 (9.4–12.4) | 11.2 (9.7–12.7) | ||
| East South Central | 9.3 (7.0–11.7) | 8.8 (6.7–11.0) | ||
| West South Central | 9.1 (7.4–10.9) | 9.2 (7.5–10.9) | ||
| Mountain | 7.7 (5.3–10.1) | 7.2 (5.1–9.3) | ||
| Pacific | 8.8 (7.0–10.6) | 8.5 (6.7–10.2) | ||
*
Computed from chi-square tests.
†
Computed from a logistic regression model adjusting for all variables listed.
‡
Quintiles calculated based on percentage of individuals in residential county at or below 125% of the federal poverty limit.