AB1567-HPR SOCIAL WORKERS: DESCRIBING SOCIOECONOMIC CHARACTERISTICS DURING PRENATAL CARE IN PATIENTS FROM A PREGNANCY AND AUTOIMMUNE RHEUMATIC DISEASES CLINIC.

Abstract

BackgroundSocial workers (SW) interventions are fundamental in health care; the main objective is to identify and mitigate social determinants of the patient’s health. The socioeconomic study (SES) is the core assessment of SW; it analyzes the demographic structure and population dynamics.ObjectivesDescribe the sociodemographic and social security characteristics in pregnant patients with autoimmune rheumatic diseases.MethodsA cross-sectional and retrospective study was conducted in a pregnancy and rheumatic diseases outpatient clinic from the university hospital in Monterrey, México. The data from the SES database was collected. The sociodemographic information, family’s monthly income and expenses, expenditures related to healthcare, type of social security, family nucleus (FN) and socioeconomic level (SL) were analized. The rheumatic diagnosis was retrieved from the medical records.The SL is classified in 7 levels (according to the score obtained in the SES); each level represents a percentage of the total cost of the healthcare received. Level 1 to 3 correspond to 0 - 28% percentage while levels 4 to 7 go from 53 to 100% of total payment that is due. To evaluate the health expenditure, the monthly limit expenditure per Mexican family is 98.39 dollars (the limit expenditure was taken from the Organization for Economic Co-operation and Development “OECD” 2019 report). For statistical analysis, the sociodemographic and clinical characteristics of the sample are presented as frequencies and percentages.ResultsFrom 2019 to 2021, 54 patients were interviewed. The mean age was 28.46 years(SD=6.69). The rheumatic diagnoses can be found in Table 1. The most common occupation was unemployment(n=34, 62.96%) and only completed basic levels of education(n=37,68.51%).Table 1.Sociodemographic characteristicsn=54Demographic DataAge, mean(SD)28.46(6.69)Occupation, n(%)Unemployed34(62.96)Employed17(31.48)Self-Employed3(5.55)Marital Status, n(%)Married/Cohabitating38(70.37)Single16(29.62)Level of Education, n(%)Basic education37(68.51)Higher education17(31.48)Family StructureFamily members, n(%)0-536(66.66)6-1118(33.32)Number of children, n(%)136(66.66)213(24.07)35(9.25)Family Nucleus, n(%)Nuclear27(50)Multi-nuclear26(48.14)Extended1(1.85)Rheumatic Disease, n (%)Rheumatoid arthritis29(53.7)Lupus9(16.66)Antiphospholipid syndrome8(14.81)Sjögren syndrome1(1.85)Health Expenditure, n(%)Active health insuranceNone39(72.22)Public health services (governmental and state workers)8(14.81)Private health insurance7(12.96)Average monthly family income (USD)$614.23Average monthly health expenditure (USD)$105.71Percentage of expenses in patient’s health16.21%SD:Standard deviationThe most frequent SL was level 3 (46.29%) and the predominant FN was the nuclear family (50%) (couple and their dependent children). Most of them were not under any health coverage(n=39, 72.22%). The average family income was $614.23 USD and the average health expenditure was 105.71 USD; which represents 16.21% of the family income (per month).ConclusionSW play a key role understanding basic needs and identifying health determinants that decreases the odds of access of healthcare. Women with autoimmune rheumatic diseases have an important burden of the main determinants of health like low income, unemployment, basic education, and poor health coverage.In addition, the average health expenditure is higher than the recommended by OECD. Different strategies are needed for childbearing age patients with rheumatic diseases to decrease the impact of health determinants.