Peer-reviewedCC BY-NCRheumatology (Oxford, England)1 Oct 2026

Impacts of socioeconomic status on ambulatory care sensitive condition hospitalizations in RA.

Isabella Hoy¹
Dani G Contreras²
Claire Barber^2,3,4,5
Cheryl Barnabe^2,3,4,5

5 affiliations

¹Department of Medicine, Faculty of Medicine Dunedin, University of Otago, Dunedin, New Zealand.
²Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.
⁵Arthritis Research Canada, Vancouver, BC, Canada.

Abstract

Objectives

Persons with RA are at increased risk for ambulatory care sensitive conditions (ACSCs) hospitalizations. 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 categorized into quintiles (Q1 privileged to Q5 deprived). Crude and adjusted incidence rate ratios (IRRs) 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), whereas cases 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.

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Cite

BibTeX RIS

BibTeX

@article{hoy2026impacts,
  title = {{Impacts of socioeconomic status on ambulatory care sensitive condition hospitalizations in RA.}},
  author = {Isabella Hoy and Dani G Contreras and Claire Barber and Cheryl Barnabe},
  journal = {Rheumatology (Oxford, England)},
  year = {2026},
  month = oct,
  doi = {10.1093/rheumatology/keag556},
  url = {https://europepmc.org/article/MED/42836705},
  note = {CC BY-NC},
}

RIS

TY  - JOUR
TI  - Impacts of socioeconomic status on ambulatory care sensitive condition hospitalizations in RA.
AU  - Isabella Hoy
AU  - Dani G Contreras
AU  - Claire Barber
AU  - Cheryl Barnabe
PY  - 2026
DA  - 2026/10/01
JO  - Rheumatology (Oxford, England)
DO  - 10.1093/rheumatology/keag556
UR  - https://europepmc.org/article/MED/42836705
AB  - Objectives  Persons with RA are at increased risk for ambulatory care sensitive conditions (ACSCs) hospitalizations. 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 categorized into quintiles (Q1 privileged to Q5 deprived). Crude and adjusted incidence rate ratios (IRRs) 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), whereas cases 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.
SN  - 1462-0324
SN  - 1462-0332
ER  -

Abstract

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