Epidemiology of Rheumatoid Arthritis (RA) in rural and urban areas of Poland – 2008–2012

Abstract

Objective. The aim of this study is to investigate the morbidity rate due to Rheumatoid Arthritis (RA) in the Polish population during 2008-2012, calculated per 1,000 inhabitants, and taking into account the differences between provincess, area of residence (urban or rural) and gender. Materials and method. From the NFZ IT systems, PESEL number information was obtained for all 17 types of services contracted in 2008-2012, for patients whose main diagnosis in the report was the ICD-10 disease code: M05.X-seropositive rheumatoid arthritis, or M06.X-other rheumatoid arthritis. The number of patients, gender and age were calculated based on the PESEL number provided in the statistical reports of the patient with the analysed ICD-10 diagnosis. Urban and rural cases were compared using commune zip codes. The basis for classifying the patient as a member of an urban or rural population was the Zip Code of the declared place of residence. Urban and rural areas are classified based on administrative criteria provided by the Central Statistical Office: the National Official Register of Territorial Division of the Country (TERYT). Results. During the studied period the number of RA patients increased from 173,844-230,892. In urban areas, the most patients were recorded in the Śląskie Province, the least in Lubuskie Province. Patients from rural areas were approx. 1/3 rd of the total population of patients in Poland. In rural areas, the most patients were recorded in the Mazowieckie Province, the least in Lubuskie Province. The morbidity rate in cities was 5.08 in 2008 and increased to 8.14 in 2012 in rural areas, respectively, it was 3.74 and increased to 3.98. Regardless of the place of residence the women fell ill 3.5 times more frequently. The lowest morbidity rate, both in rural and urban areas, was recorded in the Lubuskie Province, the largest in Świętokrzyskie Province. The the most probable explanation of the highest morbidity rate in the latter province is a worse access to a rheumatologist: in this province there is the lowest number of inhabitants per one employed rheumatologist. Conclusion. In Poland, the number of RA sufferers is increasing, which is probably a result of increasing life expectancy. In Poland, also exists a differences in morbidity between urban and rural inhabitants. Differences may also derive from undiagnosed cases of the disease.

Coping strategies observed in women with rheumatoid arthritis

“…In Poland, the number of RA sufferers is increasing [32]. People with rheumatoid arthritis experience stress caused by their disability and persistent pain and are dependent on other people.…”

Gene Expression of Tumor Necrosis Factor-Alpha in Etanercept-Treated Rheumatoid Arthritis Patients

“…The joint synovitis leads to progressive destructions in bones and cartilages, and causes significant disabilities and even permanent functional loss due to the erosion of bones surfaces if it is untreated [2]. The global prevalence of RA in adult populations is approximately 0.5% -1.0%, and it is more common in women than in men (two-to four-folds), with a most common age at onset between the fourth and sixth decade of life [3]. Pathologically, RA is mainly three steps process that begins with autoimmunity development, followed by a local inflammation and in the final step, bone destruction is induced [4].…”

Outcomes and treatment responses, including work productivity, among people with axial spondyloarthritis living in urban and rural areas: a mixed-methods study within a national register

“…A number of studies have highlighted inadequate access to specialist healthcare services for those with rheumatic and musculoskeletal disease (RMD) living in rural and remote locations. [13][14][15][16] However, in a recent systematic review of the literature, we found very limited evidence as to whether outcomes are poorer for individuals with rheumatic disease living in rural settings. 17 No eligible studies examined work outcomes.…”