The Association of Rheumatologist Supply and Multidisciplinary Care With Timely Patient Access to Rheumatologists: Evidence From British Columbia, Canada
Authors' conclusion
Access to rheumatology care improved, and the increased proportion of patients with IA in the first visits case-mix indicates that rheumatologist supply and incentives for multidisciplinary care may have improved referral patterns. However, time to DMARDs for people with RA remained long, and we found signals of unequal access for female patients and people living outside of metropolitan areas.
Study context
- Population
- All residents of British Columbia, Canada (Population Data BC), physician visits and prescribing 2010–2011 to 2019–2020149,902 new rheumatologist visits
- Outcome
- Time from referral to first rheumatologist visit; for people with RA, time to first DMARD
Methodological detailslongitudinal administrative database, quantile regression
- Longitudinal administrative database
- Quantile regression
Main finding
As reported in the abstract
Median time from referral to first visit in 2010-2011 (IQR 21-120 days)
63 days
Decrease in median time from referral to first visit over study period
22 days
35%
Observational data: associations, not effects.
Further findings
Time from referral to disease-modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA)
- Decrease in time from referral to DMARD, to 62 days
- 4 days (6%)
- Male sex, living in metropolitan areas and having a rheumatologist using a multidisciplinary care assessment code associated with shorter time from referral to first DMARD
New rheumatologist visits · 2019-2020 vs 2010-2011
- More visits in 2019-2020 than in 2010-2011
- 31%
Proportion of first visits for patients with inflammatory arthritis
- Increase from 28% to 51%
Original publication
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