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Health-related quality of life as a main determinant of access to rheumatologic care

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Abstract

To evaluate a rheumatology outpatient consultation access system for new patients. New patients seen from April 2005 to April 2006 at our rheumatology clinic (n = 4,460) were included and classified according to their appointment type: ordinary appointments (OA) to be seen within 30 days, urgent appointments (UA) and work disability appointments (WDA) to be seen within 3 days. Age, sex, diagnosis, and health-related quality of life (HRQoL) as determined by the Rosser Index were recorded. Logistic regression models were run to identify factors that contribute to each type of appointment. OA was the method of access for 1,938 new patients, while 1,194 and 1,328 patients were seen through WDA and UA appointments, respectively. Younger male patients, and those with microcrystalline arthritis, sciatica, shoulder, back, or neck pain, were more likely to use the faster access systems (UA or WDA), whereas patients with a degenerative disease were mainly seen through OA (<0.001). Subjects with poor (3.96; 95 % CI, 2.8–5.5) or very poor HRQoL (70.8; 95 % CI, 14.9–334) were strongly associated to visiting a rheumatologist through the WDA or UA access systems, respectively, compared to OA. Age, gender, diagnosis, and mainly health-related quality of life are associated with the referral pattern of access to rheumatologic outpatient care. Among new patients subjects with the worst HRQoL were more likely to access with faster methods (UA or WDA) than those with better HRQoL.

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Authors and Affiliations

  1. Rheumatology Unit, Hospital Clínico San Carlos, Calle Profesor Martin Lagos S/N, 28040, Madrid, Spain

    Leticia Leon, Juan Angel Jover, Estibaliz Loza, Cristina Lajas, Cristina Vadillo, Oscar Fontsere, Cristina Martinez & Benjamin Fernandez-Gutierrez

  2. TAISS (Tecnicas Avanzadas en Investigación en Servicios de Salud), Montreal University, Montreal, Canada

    Maria Victoria Zunzunegui

  3. Rheumatology Unit, Fundación para la Investigación Biomédica, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Calle Profesor Martin Lagos S/N, 28040, Madrid, Spain

    Leticia Leon, Luis Rodriguez–Rodriguez & Lydia Abasolo

  4. Health Sciences, Universidad Camilo Jose Cela, Calle Castillo de Alarcón 49, 28692, Madrid, Spain

    Leticia Leon

Authors
  1. Leticia Leon
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  2. Juan Angel Jover
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  3. Estibaliz Loza
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  11. Lydia Abasolo
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Correspondence to Leticia Leon.

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Leon, L., Jover, J.A., Loza, E. et al. Health-related quality of life as a main determinant of access to rheumatologic care. Rheumatol Int 33, 1797–1804 (2013). https://doi.org/10.1007/s00296-012-2599-6

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  • DOI: https://doi.org/10.1007/s00296-012-2599-6

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