Is rheumatoid arthritis care more costly when provided by rheumatologists compared with generalists?
✍ Scribed by Sherine E. Gabriel; Judith L. Wagner; Alan R. Zinsmeister; Christopher G. Scott; Harvinder S. Luthra
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 132 KB
- Volume
- 44
- Category
- Article
- ISSN
- 0004-3591
No coin nor oath required. For personal study only.
✦ Synopsis
Objective. Controversy surrounds the costeffectiveness of rheumatologist care compared with generalist care for patients with rheumatoid arthritis (RA). Rheumatologists can provide 2 distinct types of care for RA patients: primary care and specialist care. We sought to examine the relationship between cost and type of care in a population-based cohort of patients with RA.
Methods. Data regarding specialty of care and use of health services (i.e., total direct medical costs, surgeries, radiographs, laboratory tests, hospital days) were collected from a community sample of 249 patients with RA (defined using the 1987 American College of Rheumatology diagnostic criteria) among Rochester, Minnesota residents >35 years of age. In a randomly selected subset of 99 of these RA patients, detailed information on all physician encounters was collected and categorized according to whether or not the care received constituted "primary care" according to the Institute of Medicine definition. Using these data, we evaluated the influence of type of care as well as specialty of provider on utilization. For these analyses, total direct costs included all inpatient and outpatient health care costs incurred by all local providers (excluding outpatient prescription drugs).
Results. The 249 patients with RA (mean age 64 years, 75% women) were followed up for a median of 5.4