METHODS: Rheumatologists submitted data on new patients with a new diagnosis of rheumatoid factor and/or cyclic-citrullinated peptide antibody positive RA. The association between visit funding, ethnicity, socio-economic deprivation, rurality, local specialist staffing levels and the time to DMARD treatment was assessed using Cox proportional-hazard models.
RESULTS: Data were collected on 355 patients over 12 months. Overall, 64.8% of patients commenced DMARD treatment within 6 weeks of referral and this was associated with rheumatologist FTE per 100,000 population (adjusted HR 2.47, 95%CI 1.27-4.81; p=0.008) and the rurality (Geographic Classification of Health [GCH]) of the patient (for R2 compared to U1 adjusted HR 0.20, 95%CI 0.09-0.43; p<0.001). There was no association between time to DMARD and ethnicity or socio-economic deprivation.
CONCLUSIONS: There was significant variation in time to DMARD treatment, mainly related to variation in rheumatologist staffing levels and patient rurality. Rheumatologist staffing levels of 1.0 FTE/100,000 population was associated with 80% of patients meeting the recommended 6-week time to DMARD treatment.
方法:风湿病学家提交了新诊断为类风湿因子和/或环瓜氨酸肽抗体阳性RA的新患者的数据。访问资金之间的关联,种族,社会经济匮乏,rurality,使用Cox比例风险模型评估了当地专家的人员配备水平和接受DMARD治疗的时间.
结果:收集了355名患者12个月的数据。总的来说,64.8%的患者在转诊后6周内开始接受DMARD治疗,这与每100,000人的风湿病学家FTE(调整后的HR2.47,95CI1.27-4.81;p=0.008)和患者的rurality(健康地理分类[GCH])(R2与U1调整后的HR0.20,95CI0.09-0.43;p<0.001)相关。DMARD的时间与种族或社会经济匮乏之间没有关联。
结论:DMARD治疗时间有显著差异,主要与风湿病专家人员配备水平和患者乡村性的变化有关。风湿病学家的人员配备水平为1.0FTE/100,000人群,与80%的患者达到DMARD治疗的推荐6周时间相关。