Uveitis and health disparities: results from the National Inpatient Sample

Abstract

PurposeHealth disparities exist when the prevalence or outcome of the disease are influenced by age, race, sex or income. Health disparities are prevalent in autoimmune diseases. However, there is a lack of national US data regarding health disparities in uveitis. The primary aim of our study is to evaluate health disparities for uveitis in the USA.MethodsWe performed a retrospective, observational, cross-sectional study to ascertain health disparities for uveitis and its complications in the USA using the National Inpatient Sample (NIS) for the years 2002–2013. We used the International Classification of Disease, ninth revision, codes to identify uveitis cases and ocular complications. Uveitis was divided into total, infectious and non-infectious uveitis. We collected information on age, sex, race, income quartile and ocular complications. We preformed statistical analysis using SAS V.9.4. A logistic regression model was used to predict the odds of developing uveitis and its complications.ResultsThere were a total of 94 143 978 discharges including 15 296 total uveitis, 4538 infectious and 10 758 non-infectious uveitis patients. Compared with the total NIS population, patients with uveitis were younger (mean age 45±18 vs 48±28 years, p value ≤0.0001, African-Americans (23% vs 10%, p value ≤0.0001), in the lowest income quartile (<$38 999; 29% vs 26%, p value ≤0.0001) and were insured by Medicaid (25% vs 20%, p value ≤0.0001).ConclusionAfrican-American patients have a higher prevalence of uveitis. Patients insured by Medicare and Medicaid have more frequent ocular complications. This knowledge may guide future research on disparity and shape healthcare decision making.