Facilitated access to an integrated model of care for arthritis in an urban Aboriginal population

Objective To evaluate a model of care to improve arthritis detection and treatment in an urban Aboriginal population. Design Cohort study. Setting The Elbow River Healing Lodge in Calgary, Alta. Participants A total of 26 participants with noninflammatory arthritis and 12 with inflammatory arthritis. Intervention A monthly rheumatology clinic was embedded in the primary health care service and received referrals from primary care providers and allied health care professionals, or self-referrals. All participants had a standardized assessment to determine their diagnosis. Those with noninflammatory musculoskeletal conditions were returned to primary care management and those with inflammatory arthritis conditions were followed by the rheumatologist. Main outcome measures Accessibility, acceptability, effectiveness, and cultural safety were evaluated as measures of quality for the model of care. Results Nearly all participants (87%) thought the services were very easy or easy to obtain, and overall satisfaction with the model of care was high (89% were very satisfied or satisfied). For inflammatory arthritis patients, the swollen and tender joint counts improved over time (both P <.01) and patient safety was assured. A high degree of cultural safety was provided, with 95% of participants responding that they did not perceive discrimination on the basis of race. Conclusion This model of care facilitated access for diagnosis and return to care of inflammatory arthritis conditions, and was acceptable to participants. This model of care removes the complexities of access to non-family physician specialty care while providing health care in a setting valued by Aboriginal patients.