Testing population-based performance measures identifies gaps in juvenile idiopathic arthritis (JIA) care

被引:6
|
作者
Barber, Claire E. H. [1 ,3 ]
Lix, Lisa M. [2 ]
Lacaille, Diane [3 ,13 ]
Marshall, Deborah A. [3 ,4 ]
Kroeker, Kristine [5 ]
Benseler, Susanne [6 ]
Twilt, Marinka [6 ]
Schmeling, Heinrike [6 ]
Barnabe, Cheryl [1 ,3 ]
Hazlewood, Glen S. [1 ,3 ]
Bykerk, Vivian [7 ]
Homik, Joanne [8 ]
Thorne, J. Carter [9 ]
Burt, Jennifer [10 ]
Mosher, Dianne [11 ]
Katz, Steven [11 ]
Shiff, Natalie J. [12 ]
机构
[1] Univ Calgary, Cumming Sch Med, Dept Med, Div Rheumatol, 3330 Hosp Dr NW, Calgary, AB T2N 4N1, Canada
[2] Univ Manitoba, S113-750 Bannatyne Ave, Winnipeg, MB R3E 0W3, Canada
[3] Arthrit Res Canada, 5591 3 Rd, Richmond, BC V6X 2C7, Canada
[4] Univ Calgary, Cumming Sch Med, Dept Community Hlth Sci, 3280 Hosp Dr NW, Calgary, AB T2N 4Z6, Canada
[5] George & Fay Yee Ctr Healthcare Innovat, 3rd Floor,753 McDermot Ave, Winnipeg, MB R3E 0T6, Canada
[6] Alberta Childrens Prov Gen Hosp, 28 Oki Dr, Calgary, AB T3B 6A8, Canada
[7] Hosp Special Surg, 535 E 70th St, New York, NY 10021 USA
[8] Edmonton Clin, Med Clin 3A, Third Floor,11400 Univ Ave, Edmonton, AB T6G 1Z1, Canada
[9] 43 Lundys Lane, Newmarket, ON L3Y 3RY, Canada
[10] St Clares Mercy Hosp, Rheumatol Serv, 154 LeMarchant Rd, St John, NF A1C 5B8, Canada
[11] Edmonton Clin, Third Floor,11400 Univ Ave, Edmonton, AB T6G 1Z1, Canada
[12] Univ Saskatchewan, Dept Community Hlth & Epidemiol, Box 7,107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
[13] Univ British Columbia, Dept Med, Vancouver, BC, Canada
关键词
Juvenile idiopathic arthritis; Quality improvement; Quality Indicator; PEDIATRIC RHEUMATOLOGY; CHILDHOOD ARTHRITIS; YOUNG-PEOPLE; CHILDREN; DISEASE; PREDICTORS; STANDARDS; SYMPTOMS; ACCESS; TIME;
D O I
10.1186/s12913-019-4379-4
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background The study evaluates Performance Measures (PMs) for Juvenile Idiopathic Arthritis (JIA): The percentage of patients with new onset JIA with at least one visit to a pediatric rheumatologist in the first year of diagnosis (PM1); and the percentage of patients with JIA under rheumatology care seen in follow-up at least once per year (PM2). Methods Validated JIA case ascertainment algorithms were used to identify cases from provincial health administrative databases in Manitoba, Canada in patients < 16 years between 01/04/2005 and 31/03/2015. PM1: Using a 3-year washout period, the percentage of incident JIA patients with >= 1 visit to a pediatric rheumatologist in the first year was calculated. For each fiscal year, the proportion of patients expected to be seen in follow-up who had a visit were calculated (PM2). The proportion of patients with gaps in care of > 12 and > 14 months between consecutive visits were also calculated. Results One hundred ninety-four incident JIA cases were diagnosed between 01/04/2008 and 03/31/2015. The median age at diagnosis was 9.1 years and 71% were female. PM1: Across the years, 51-81% of JIA cases saw a pediatric rheumatologist within 1 year. PM2: Between 58 and 78% of patients were seen in yearly follow-up. Gaps > 12, and > 14, months were observed once during follow-up in 52, and 34%, of cases, and >= twice in 11, and 5%, respectively. Conclusions Suboptimal access to pediatric rheumatologist care was observed which could lead to diagnostic and treatment delays and lack of consistent follow-up, potentially negatively impacting patient outcomes.
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页数:7
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