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Wait Times for Rheumatology Consultation: Is Rheumatoid Arthritis Prioritized?

Delaurier, Ashley MSc, PT*†; Bernatsky, Sasha MD, PhD; Baron, Murray MD§; Légaré, Jean PhD; Feldman, Debbie Ehrmann PhD, PT*†

JCR: Journal of Clinical Rheumatology: October 2012 - Volume 18 - Issue 7 - p 341–344
doi: 10.1097/RHU.0b013e31826d6408
Original Articles

Objectives: Patients with rheumatoid arthritis (RA) should be seen by a rheumatologist promptly; however, there are no recommendations for patients with osteoarthritis (OA). Our goal was to describe wait times from referral by the primary care provider to rheumatology consultation and to explore whether wait times are associated with type of arthritis diagnosis, geographic area, or type of rheumatology office.

Methods: Appointments were requested by telephone using case scenarios that were created by a group of experts and included (1) presumed RA, (2) possible RA, and (3) presumed OA. Wait times were evaluated as the time between the initial request and the appointment date provided. We used descriptive statistics, bivariate analysis, and logistic regression in the analysis.

Results: For all scenarios combined, 34% were given an appointment with a rheumatologist within 3 months of referral, 32% waited longer than 3 months, and 34% were told that the rheumatologist was not accepting new referrals at the time the request was made. Patients with presumed RA were much more likely to be seen within 3 months of referral compared with those with presumed OA (odds ratio, 13; 95% confidence interval, 1.70-99.38).

Conclusions: Rheumatoid arthritis is prioritized over OA for rheumatology appointments. However, most patients with RA are still not receiving an appointment to a rheumatologist in a timely manner. Effective triage tools to decrease these delays should be instituted.

From the *University of Montreal, Faculty of Medicine, School of Rehabilitation; †Direction de la Santé Publique de Montréal and Institut National de Santé Publique du Québec, Équipe Santé des Populations et Services de Santé; ‡Division of Epidemiology, Jewish General Hospital and McGill University; §Division of Rheumatology, McGill University Health Centre, Jewish General Hospital, Montreal; and ∥Consumer Advisory Council, Canadian Arthritis Network Centres of Excellence, Toronto, Canada.

This study was supported by the Canadian Initiatives for Outcomes in Rheumatology cAre (CIORA), Ordre Professionnel de la Physiothérapie du Québec (OPPQ), and l’Université de Montréal Faculté de Médecine (Bourse de rédaction).

Drs Feldman and Bernatsky are supported by career awards from the Fonds de Recherche du Québec–Santé.

The authors declare no conflict of interest.

Correspondence: Debbie Ehrmann Feldman, PhD, PT, Pavillon 7077 du Parc, École de Réadaptation, Faculté de Médecine, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec, Canada H3C 3J7. E-mail: debbie.feldman@umontreal.ca.

© 2012 Lippincott Williams & Wilkins, Inc.