POS1143 TOTAL COST RISK SCORES AND BARRIER CATEGORIES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ASSOCIATED FACTORS
Authors: M. Magrey, O. Pamuk, Y. Raghuwanshi, T. Barnett
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is associated with an increased risk of morbidity and mortality. Epidemiological studies indicate significant health disparities in SLE, with poverty, chronic socio-economic stressors, low medication adherence, and limited healthcare access being key contributing factors to these disparities. <h3>Objectives:</h3> In this study, we aimed to evaluate the Total Cost Risk Score (TCRS) and Barriers category (BC) in patients with SLE and associated factors. <h3>Methods:</h3> The study comprised 216 SLE patients meeting the ACR-modified 1997 criteria and 128 controls. The control group consisted of patients from the Rheumatology outpatient clinic between 2018-2023, with 106 having fibromyalgia and 22 having osteoarthritis. Clinical and demographic features of SLE patients were extracted from the EMR, while TCRS and BC data were sourced from the Lexis Nexis/ SDOH database. TCRS system comprises various sections that assess the socioeconomic factors and risk levels associated with members/patients. Sections of TCRS are shown in Figure 1A. The scoring system determines the mean TCRS, socioeconomic ranking (0-100), and socioeconomic category classes (ranging from extremely high to very low-risk percentiles). The BC, formerly known as the Motivation category; encompasses various sections that evaluate individuals' predicted motivation levels and their commitment to self-health management. Sections of BC are shown in Figure 1B. Moreover, the BC is associated with five risk levels: extremely high, high, medium, low, and very low. For statistical analysis, chi-square and Mann-Whitney U tests were utilized. <h3>Results:</h3> The median TCRS index score is significantly higher in SLE patients when compared to controls (p=0.04). Also, the frequency of extremely high/high-risk socioeconomic category is significantly higher in SLE patients when compared to controls (52.3% vs. 34.4%, p=0.0001) (Table 1). The mean BC scores and BC categories are similar in patients with SLE and controls (Table 1). In SLE patients, socioeconomic risk categories are similar in AA and white patients. Major organ involvement (nephritis, central nervous system disease, severe hematological disease) was detected in 75 SLE patients. Socioeconomic index (TCRS) and Motivation categories (BC) are similar in SLE patients with and without major organ involvement. In African American SLE patients with major organ involvement, the frequency of the extremely high/high-risk category tends to be higher than in white patients (61% vs. 36%, p=0.08). <h3>Conclusion:</h3> Our study revealed that more than half of the SLE patients are in the high-risk socioeconomic category, and their total cost-risk score is significantly higher than that of the controls. This finding could be a crucial contributing factor to health disparities in SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>