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Best Pract Res Clin Rheumatol. 2012 Oct;26(5):561-83. doi: 10.1016/j.berh.2012.08.002.

Access to self-management education, conservative treatment and surgery for arthritis according to socioeconomic status.

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Melbourne EpiCentre, Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville Victoria 3050, Australia.


There is now a considerable body of research investigating inequities in access to health care for arthritis according to socioeconomic status (SES). Conducted in a range of settings internationally, studies have examined specific socioeconomic factors (including education, income, deprivation and health insurance status) in relation to access to treatment. This chapter provides a comprehensive review of the available evidence on disparities in access to self-management education, conservative therapy and surgical treatment for arthritis, according to SES. There is some evidence of SES disparities in access to self-management education and advice, primary care, specialist care, physical therapy and medications, and strong evidence that people with less education or lower income experience significant disparities in access to joint replacement surgery. In view of research indicating that disparities may adversely affect patient outcomes, examples of initiatives designed to optimise access to care for disadvantaged groups are also described.

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