{"id":13213,"date":"2023-02-01T00:00:00","date_gmt":"2023-02-01T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/the-effects-of-continuity-of-rheumatology-care-on-emergency-department-utilization-and-hospitalizations-for-individuals-with-early-rheumatoid-arthritis-a-population-based-study\/"},"modified":"2023-11-21T15:28:20","modified_gmt":"2023-11-21T20:28:20","slug":"the-effects-of-continuity-of-rheumatology-care-on-emergency-department-utilization-and-hospitalizations-for-individuals-with-early-rheumatoid-arthritis-a-population-based-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-effects-of-continuity-of-rheumatology-care-on-emergency-department-utilization-and-hospitalizations-for-individuals-with-early-rheumatoid-arthritis-a-population-based-study\/","title":{"rendered":"The effects of continuity of rheumatology care on emergency department utilization and hospitalizations for individuals with early rheumatoid arthritis: a population-based study"},"content":{"rendered":"<p><strong>Objective<\/strong> \u2014 To determine if continuity of rheumatology care influences rates of emergency department (ED) visits and hospitalizations in patients with rheumatoid arthritis (RA).<\/p>\n<p><strong>Methods<\/strong> \u2014 A closed inception cohort of patients with RA diagnosed between 2000 and 2009 were followed until December 31, 2019. During the first 5 years following diagnosis, we categorized patients into 3 rheumatology care continuity groups (high, intermediate, and not retained in rheumatology care). Using a landmark analysis, we compared rates of ED visits and hospitalizations during follow-up. Multivariable Poisson regression models were used to estimate rate ratios (RRs), adjusting for demographics, comorbidities, and health services access and supply measures.<\/p>\n<p><strong>Results<\/strong> \u2014 The cohort included 38,528 patients, of which 57.7% (n = 22,221) were classified in the high rheumatology continuity group, 17.2% (n = 6636) were in the intermediate group, and 25.1% (n = 9671) were not retained in rheumatology care. Relative to the high continuity group, both the intermediate and nonretention groups had higher ED rates (RR 1.14, 95% CI 1.08-1.20, and RR 1.12, 95% CI 1.08-1.16, respectively). The intermediate group also experienced higher adjusted hospitalization rates (207.4, 95% CI 203.0-211.8 per 1000 person-years [PY]) than the high continuity group (193.5, 95% CI 191.4-195.6 per 1000 PY).<\/p>\n<p><strong>Conclusion<\/strong> \u2014 Patients with RA with higher continuity of rheumatology care had lower rates of ED visits and hospitalizations compared to those who did not receive continuous rheumatology care during the first 5 years of follow-up. These findings provide evidence to support the value of early and continuous rheumatology care for reducing hospitalizations and ED visits.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objective \u2014 To determine if continuity of rheumatology care influences rates of emergency department (ED) visits and hospitalizations in patients with rheumatoid arthritis (RA). Methods \u2014 A closed inception cohort of patients with RA diagnosed between 2000 and 2009 were followed until December 31, 2019. During the first 5 years following diagnosis, we categorized patients [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,51],"migration-helper-qa-sample-set":[],"class_list":["post-13213","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-musculoskeletal-diseases-and-disorders"],"acf":{"citation":"Davtyan Abel, Lee JJY, Eder L, Hawker GA, Luo J, Barber CEH, Thorne JC, Widdifield J. <em>J Rheumatol<\/em>. 2023; 50(6):748-53. Epub 2023 Feb 1.","source_url":"https:\/\/doi.org\/10.3899\/jrheum.220996","ices_scientist":[1267,1122],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"C1CA0AB9-B31E-4933-B550-AA1B940D64E1","sitecore_item_name":"The-effects-of-continuity-of-rheumatology-care-onemergency-department-utilization","sitecore_field_values":"{\r\n  \"Title\": \"The effects of continuity of rheumatology care on emergency department utilization and hospitalizations for individuals with early rheumatoid arthritis: a population-based study\",\r\n  \"Short title\": \"The effects of continuity of\",\r\n  \"Summary\": \"The study aim was to determine if continuity of rheumatology care influences rates of ED visits and hospitalizations in patients with rheumatoid arthritis\",\r\n  \"Citation\": \"<p>Davtyan Abel, Lee JJY, Eder L, Hawker GA, Luo J, Barber CEH, Thorne JC, Widdifield J. <em>J Rheumatol<\/em>. 2023; Feb 1 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.3899\/jrheum.220996\" title=\"opens external link\">https:\/\/doi.org\/10.3899\/jrheum.220996<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Objective<\/strong> &mdash; To determine if continuity of rheumatology care influences rates of emergency department (ED) visits and hospitalizations in patients with rheumatoid arthritis (RA).<\/p>n<p><strong>Methods<\/strong> &mdash; A closed inception cohort of patients with RA diagnosed between 2000 and 2009 were followed until December 31, 2019. During the first 5 years following diagnosis, we categorized patients into 3 rheumatology care continuity groups (high, intermediate, and not retained in rheumatology care). Using a landmark analysis, we compared rates of ED visits and hospitalizations during follow-up. Multivariable Poisson regression models were used to estimate rate ratios (RRs), adjusting for demographics, comorbidities, and health services access and supply measures.<\/p>n<p><strong>Results<\/strong> &mdash; The cohort included 38,528 patients, of which 57.7% (n = 22,221) were classified in the high rheumatology continuity group, 17.2% (n = 6636) were in the intermediate group, and 25.1% (n = 9671) were not retained in rheumatology care. Relative to the high continuity group, both the intermediate and nonretention groups had higher ED rates (RR 1.14, 95% CI 1.08-1.20, and RR 1.12, 95% CI 1.08-1.16, respectively). The intermediate group also experienced higher adjusted hospitalization rates (207.4, 95% CI 203.0-211.8 per 1000 person-years [PY]) than the high continuity group (193.5, 95% CI 191.4-195.6 per 1000 PY).<\/p>n<p><strong>Conclusion<\/strong> &mdash; Patients with RA with higher continuity of rheumatology care had lower rates of ED visits and hospitalizations compared to those who did not receive continuous rheumatology care during the first 5 years of follow-up. These findings provide evidence to support the value of early and continuous rheumatology care for reducing hospitalizations and ED visits.<\/p>\",\r\n  \"ICES Scientists\": \"{4D93CE4E-174C-4555-9897-9FAE06C5C9CE}|{18222753-0014-47B0-8609-88877B722E68}\",\r\n  \"Posted Date\": \"20230201T000000\",\r\n  \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/February\/The-effects-of-continuity-of-rheumatology-care-onemergency-department-utilization"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | The effects of continuity of rheumatology care on emergency department utilization and hospitalizations for individuals with early rheumatoid arthritis: a population-based study<\/title>\n<meta name=\"description\" content=\"Objective \u2014 To determine if continuity of rheumatology care influences rates of emergency 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