A retrospective review of rheumatology referral wait times within a health centre in Quebec, Canada

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• 作者：Junyi Qian (1)
  D. Ehrmann Feldman (2)
  Asvina Bissonauth (1)
  Henri-André Ménard (3)
  Pantelis Panopalis (3)
  Michael Stein (3)
  Jennifer Lee (1)
  Sasha Bernatsky (1) (3)
  
• 关键词：Retrospective review ; Wait times ; Inflammatory arthropathies
• 刊名：Rheumatology International
• 出版年：2010
• 出版时间：March 2010
• 年：2010
• 卷：30
• 期：5
• 页码：705-707
• 全文大小：146KB
• 参考文献：1. Westhoff G, Schneider M, Raspe H, Zeidler H, Runge C, Volmer T, Zink A (2009) Advance and unmet need of health care for patients with rheumatoid arthritis in the German population—results from the German Rheumatoid Arthritis Population Survey (GRAPS). Rheumatology (Oxf) 48(6):650-57 CrossRef
  2. Feldman D, Bernatsky S, Haggerty J, Leffondré K, Taousignant P, Roy Y et al (2007) Delay in consultation with specialists for persons with suspected new-onset rheumatoid arthritis: a population-based study. Arthritis Rheum 57:1419-425 CrossRef
  3. Potter T, Mulherin D, Pugh M, Emery P, Quinn M, Conaghan P (2002) Early intervention with disease-modifying therapy for rheumatoid arthritis: where do the delays occur? Rheumatology (Oxf) 41:953-55 CrossRef
  4. Macgregor D, Parker S, Macmillan S, Blais I, Wong E, Robertson CJ et al (2009) Innovation in managing the referral process at a Canadian pediatric hospital. Healthcare 12(3):72
  
• 作者单位：Junyi Qian (1)
  D. Ehrmann Feldman (2)
  Asvina Bissonauth (1)
  Henri-André Ménard (3)
  Pantelis Panopalis (3)
  Michael Stein (3)
  Jennifer Lee (1)
  Sasha Bernatsky (1) (3)
  
  1. Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre (RI-MUHC), Royal Victoria Hospital, 687 Pine Avenue West, V-Building, Room V2.09, Montreal, QC, Canada
  2. école de réadaptation, University of Montreal, Montreal, QC, Canada
  3. Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada
  

文摘

It is important that inflammatory arthropathies such as rheumatoid arthritis be diagnosed promptly so that treatment can be administered in a timely fashion. However, there is considerable evidence that this process of care is delayed in many people. The aim of the study is to assess wait times between primary care referral and rheumatology assessment for new-onset inflammatory arthropathies. We performed a retrospective review related to new rheumatology consultations (N?=?202) between September and November 2008 within the McGill University Health Centre, Montreal, Canada. At this centre, no formal triaging of rheumatology referrals exists. Of the 202 charts reviewed, wait times could be calculated in 164 cases. Only consultations for new-onset conditions were analyzed (N?=?161). The results showed that patients with inflammatory arthritis were seen approximately 34.6?days (median 26) post-referral. Wait times for individuals who were ultimately diagnosed with non-urgent conditions (osteoarthritis, fibromyalgia and soft-tissue rheumatism) averaged 41.0?days (median 29). In conclusions, compared to non-urgent cases, individuals with inflammatory arthritis were seen about 1?week sooner. Nevertheless, provisional diagnosis provided on referrals did not appear to expedite wait times for persons with suspected inflammatory arthritis. This suggested that other factors, such as the concern of the patient, may have an influence on referral wait times. Implementation of a rapid access program or triage system may be helpful to further decrease wait times for inflammatory arthropathies.