Clinical activity in outpatient rheumatology clinics in Galicia (Spain)

Objectives: To analyze patients attending rheumatology units of the public health service in Galicia (Spain). Patients and methods: We performed a multicenter study. Outpatients from all rheumatology clinics of the Galician health service were included over a 1-week period. Results: A total of 1,357 outpatients were studied (422 new patients and 935 follow-up patients). The mean ages were 55.1 +/- 15.6 and 56.9 +/- 16.7 years, respectively. Among new patients, 22.5% had inflammatory disease, and 77.5% had noninflammatory disorders. The main source of patient referral was primary care. The overall kappa index in the analysis of agreement between the diagnosis of the referring physician and that of the rheumatologist was 0.8 (95% CI: 0.73-0.86). Agreement was appreciably lower in the group with inflammatory diseases. Among follow-up patients, those with a diagnosis of inflammatory disorders represented 63.4% of the total. This group showed a higher score in the HAQ test and had a greater frequency of patients with permanent work disability. Overall, patients with inflammatory disease required longer consultations than the remaining patients, and their discharge rate was considerably lower. Conclusions: In rheumatology outpatient clinics, patients with inflammatory diseases are more numerous, spend longer in consultations, have greater disability, are more likely to show permanent work disability, and tend to accumulate with the passage of time. Agreement was high in the diagnosis of noninflammatory diseases, contrasting with the high referral rate.