This retrospective observational study used U.S. insurance claims data (Jan 2016–Sep 2023) to assess how social determinants of health — race/ethnicity, household income, and rural/urban residency — affect healthcare resource utilization (HCRU) in newly diagnosed hereditary angioedema (HAE) patients with 24 months of continuous post-index enrollment.
Black patients had a 50% higher risk of HAE-related ED visits (RR 1.50), 2.33× more ED visits, and 2.25× higher hospitalization rates vs. White patients; lower-income patients (<$50K/year) had a 44% higher ED visit risk (RR 1.44) but no significant difference in hospitalization risk; Hispanic/Latino patients had 1.71× more ED visits vs. White patients; rural residency showed no significant effect. Allergist/immunologist access was lowest among Black patients (16.7%) and lower-income patients (25.5%) vs. the overall cohort (27.5%).
- Claims data cannot confirm diagnosis accuracy or attack severity, which may confound HCRU comparisons. - The closed insurance claims database excludes uninsured patients, likely underrepresenting the most socioeconomically disadvantaged. - Race/ethnicity and income were derived from administrative data, which may introduce misclassification.
Black and lower-income HAE patients face markedly higher ED utilization and lower specialist access — clinicians and health systems should prioritize proactive outreach and specialist referral for these groups. Ensuring on-demand and prophylactic HAE therapy is accessible to underserved patients may reduce preventable ED visits and hospitalizations.
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