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Vol. 5. Issue 4.
Pages 153-157 (July - August 2009)
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Vol. 5. Issue 4.
Pages 153-157 (July - August 2009)
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Characterization of patients with rheumatoid arthritis according to the health care level
Caracterización de pacientes con arthritis reumatoide según el nivel asistencial
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Daniel Roig Vilasecaa,
Corresponding author
26188drv@comb.es

Corresponding author.
, Montserrat Núñez Juárezb, Esther Núñez Juárezc, José Luis del Val Garcíac, Àlex Sánchez Plàd, Maria Bonet Llorache, on behalf of the ARQUALIS group 1
a Unitat de Reumatología, CAE Cornellà, SAP Baix Llobregat, Barcelona, Spain
b Servicio de Reumatología, Instituto Clínico de Especialidades Medico-Quirúrgicas (ICEMEQ), Hospital Clínic, Barcelona, Spain
c SAP Suport al Diagnòstic i al Tractament, Institut Català de la Salut, Barcelona, Spain
d Departamento de Estadística, Universidad de Barcelona, Barcelona, Spain
e Servicio de Reumatología, Hospital de l’Alt Penedes, Barcelona, Spain
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Abstract
Objective

To characterize rheumatoid arthritis patients seen in rheumatology units at different health care levels.

Material and methods

Questionnaire and clinical examination of rheumatoid arthritis patients seen as outpatients in rheumatology units from primary care, county hospitals and reference hospitals. Demographic, social, labor, and disease data were collected. Statistical study included a description of the variables and a multiple correspondence analysis to define patient profiles.

Results

Eight hundred and twelve patients with rheumatoid arthritis were included. There were significant differences in patient profiles at the different care level. In primary care, patients were older, with basic studies, and with short duration and generally mild rheumatoid arthritis. In local hospitals the typical patient was a man, qualified worker, with low income, and an erosive disease with extraarticular manifestations. At reference hospitals prevailing patients were young women with a long duration disease and requiring biological therapy.

Conclusion

There are significant differences in rheumatoid arthritis patient profiles at different health care levels.

Keywords:
Rheumatoid arthritis Health care system Population characteristics Clinical characteristics
Resumen
Objetivo

Determinar las características de los pacientes con artritis reumatoide (AR) que acuden a consultas de reumatología en diferentes niveles asistenciales.

Material y métodos

Entrevista y evaluación clínica a pacientes con AR en consultas de reumatología de centros de especialidades, de atención primaria y de hospitales comarcales y de tercer nivel. Se recogieron datos generales, sociolaborales y de la enfermedad. Se realizó un estudio descriptivo y un análisis de correspondencias múltiples para establecer perfiles característicos.

Resultados

Se entrevistaron 812 pacientes. Se observaron diferencias significativas entre las características de los pacientes de cada nivel asistencial. En las consultas de reumatología de atención primaria predominan los pacientes de edad avanzada (mayores de 75 años), con estudios básicos y con un tipo de enfermedad de poco tiempo de evolución y, en general, poco grave. En los hospitales comarcales predominan los pacientes varones, obreros cualificados, con ingresos bajos, enfermedad erosiva y manifestaciones extraarticulares. En los hospitales de tercer nivel predominan las mujeres jóvenes con estudios, que padecen una enfermedad de larga evolución y que requieren tratamiento biológico.

Conclusión

Hay diferencias significativas en las características de los pacientes que acuden a cada uno de los niveles asistenciales.

Palabras clave:
Artritis reumatoide Sistema de salud Características de la población Características clínicas
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References
[1.]
D.H. Solomon, D.W. Bates, R.S. Panush, J.N. Katz.
Costs, outcomes, and patient satisfaction by provider type for patients with rheumatic and musculoskeletal conditions: A critical review of the literature and proposed methodologic standards.
Ann Intern Med, 127 (1997), pp. 52-60
[2.]
J.A. Skouen, A. Grasdal, E.M.H. Haldorsen.
Return to work after comparing outpatient patient multidisciplinary treatment programs versus treatment in general practice for patients with chronic widespread pain.
Eur J Pain, 10 (2006), pp. 145-152
[3.]
M. Muñoz Álamo, R. Ruiz Moral, L.A. Pérula de Torres.
Evaluation of a patient-centred approach in generalized musculoskeletal chronic pain/fibromyalgia patients in primary care.
Patient Educ Couns, 48 (2002), pp. 23-31
[4.]
F.M. Hecht, I.B. Wilson, A.W. Wu, R.L. Cook, B.J. Turner.
for the Society of General Internal Medicine AIDS Task Force.
Ann Intern Med, 131 (1999), pp. 136-143
[5.]
P. Emery, F.C. Breedveld, M. Dougados, J.R. Kalden, M.H. Schiff, J.S. Smolen.
Early referral recommendation for newly diagnosed rheumatoid arthritis: Evidence based development of a clinical guide.
Ann Rheum Dis, 61 (2002), pp. 290-297
[6.]
H.L. Mitchell, A.J. Carr, D.L. Scott.
The management of knee pain in primary care: Factors associated with consulting the GP and referrals to secondary care.
Rheumatology, 45 (2006), pp. 771-776
[7.]
D. Reina Sanz, J. del Blanco, M. Bonet, C. Castaño, T. Clavaguera, L. Mateo, et al.
Capacidad funcional en la artroparía psoriásica: análisis de 343 pacientes.
Med Clín (Barc), 129 (2007), pp. 201-204
[8.]
L. Carmona, J. Ballina, R. Gabriel, A. Laffon.
on behalf of the EPISER study gruop. The burden of musculoskeletal diseases in the general population of Spain: Results from the National Survey.
Ann Rheum Dis, 60 (2001), pp. 1040-1045
[9.]
F. Wolfe, H.A. Smythe, M.B. Yunus, R.M. Bennett, C. Bombardier, D.L. Goldenberg, et al.
The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee.
Arthritis Rheum, 33 (1990), pp. 160-172
[10.]
M.M. Ward, J.P. Leigh, J.F. Fries.
Progression of functional disability in patients with rheumatoid arthritis.
Associations with Rheumatology subspecialty care. Arch Int Med, 153 (1993), pp. 2229-2237
[11.]
E.M. Badley.
Arthritis in Canada: What do we know and what should we know.
J Rheumatol, 32 (2005), pp. 39-41
[12.]
A.-C. Rat, V. Henegariu.
Boissier M-C. Do primary care physicians have a place in the management of rheumatoid arthritis?.
Joint Bone Spine, 71 (2004), pp. 190-197
[13.]
J. Sieper, M. Rudwaleit.
Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care.
Ann Rheum Dis, 64 (2005), pp. 659-663
[14.]
I. Larizgoitia, B. Starfield.
Reform of the primary health care: The case of Spain.
Health Policy, 41 (1997), pp. 121-137
[15.]
K.M.J. Douglas, T. Potter, G.J. Treharne, K. Obrenovic, E.D. Hale, A. Pace, et al.
Rheumatology patient preferences for timing and location of out-patients clinic.
Rheumatology, 44 (2005), pp. 80-82
[16.]
M.M. Ward.
Health services in Rheumatology.
Curr Op Rheumatol, 12 (2000), pp. 99-103
[17.]
Y. Alamanos, A.A. Drosos.
Epidemiology of adult rheumatoid artritis.
Autoimmunity Rev, 4 (2005), pp. 130-136

Other members of the ARQUALIS group: C. Alegre (Hospital Vall d’Hebron, Barcelona), X. Alzaga (SAP Muntanya, Barcelona), X. Arasa (Hospital Verge de la Cinta, Tortosa, Tarragona), D. Boquet (Hospital Arnau de Vilanova, Lleida), M.A. Campillo (SAP Dreta, Barcelona), M. Carandell (Hospital Sant Camil, Sant Pere de Ribes, Barcelona), M. Centelles (Hospital de Mataró, Mataró, Barcelona), T. Clavaguera (Hospital de Palamós, Palamós, Girona), L. Figueiras (SAP Cerdanyola, Cerdanyola del Vallés, Barcelona), C. Hoces (SAP Baix Llobregat Centre, Cornellà de Llobregat, Barcelona), E. Llopart (SAP Muntanya, Barcelona), M.D. Muñoz (Institut d’Estudis de la Salut), S. Ordóñez (Hospital Arnau de Vilanova, Lleida), M.R. Oriach (SAP Dreta, Barcelona), C. Trabado (SAP Esquerra, Barcelona).

Copyright © 2009. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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