Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis
Abstract Background Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks f...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12969-020-0413-7 |
| _version_ | 1818997937490886656 |
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| author | Claire E. H. Barber Cheryl Barnabe Susanne Benseler Ricky Chin Nicole Johnson Nadia Luca Paivi Miettunen Marinka Twilt Dwaraka Veeramreddy Natalie J. Shiff Heinrike Schmeling |
| author_facet | Claire E. H. Barber Cheryl Barnabe Susanne Benseler Ricky Chin Nicole Johnson Nadia Luca Paivi Miettunen Marinka Twilt Dwaraka Veeramreddy Natalie J. Shiff Heinrike Schmeling |
| author_sort | Claire E. H. Barber |
| collection | DOAJ |
| description | Abstract Background Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs. Methods This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein. Results The median age at diagnosis was 8.0 years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22 days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (p = 0.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5 days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, p = 0.005). Conclusion Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs. |
| first_indexed | 2024-12-20T21:53:34Z |
| format | Article |
| id | doaj.art-bf8e12a61548499db7a941c50032d138 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-12-20T21:53:34Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-bf8e12a61548499db7a941c50032d1382022-12-21T19:25:30ZengBMCPediatric Rheumatology Online Journal1546-00962020-03-011811510.1186/s12969-020-0413-7Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritisClaire E. H. Barber0Cheryl Barnabe1Susanne Benseler2Ricky Chin3Nicole Johnson4Nadia Luca5Paivi Miettunen6Marinka Twilt7Dwaraka Veeramreddy8Natalie J. Shiff9Heinrike Schmeling10Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of CalgaryDivision of Rheumatology, Department of Medicine, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryDivision of Rheumatology, Department of Medicine, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryAlberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryDepartment of Community Health and Epidemiology, University of Saskatchewan (adjunct)Alberta Children’s Hospital, Department of Pediatrics, Cumming School of Medicine, University of CalgaryAbstract Background Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs. Methods This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein. Results The median age at diagnosis was 8.0 years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22 days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (p = 0.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5 days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, p = 0.005). Conclusion Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs.http://link.springer.com/article/10.1186/s12969-020-0413-7ArthritisJuvenileQuality of health careWait times |
| spellingShingle | Claire E. H. Barber Cheryl Barnabe Susanne Benseler Ricky Chin Nicole Johnson Nadia Luca Paivi Miettunen Marinka Twilt Dwaraka Veeramreddy Natalie J. Shiff Heinrike Schmeling Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis Pediatric Rheumatology Online Journal Arthritis Juvenile Quality of health care Wait times |
| title | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| title_full | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| title_fullStr | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| title_full_unstemmed | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| title_short | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| title_sort | patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
| topic | Arthritis Juvenile Quality of health care Wait times |
| url | http://link.springer.com/article/10.1186/s12969-020-0413-7 |
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