title: Health care utilization among rheumatoid arthritis patients referred to a rheumatology center: unequal needs, unequal care?
abstract: OBJECTIVE
  To quantify the utilization of health care by rheumatoid arthritis (RA) patients and to estimate the contribution of patient characteristics to the explanation of the use of care, in order to evaluate whether those in need of care actually receive care.
  
  
  METHODS
  A questionnaire survey and a clinical examination were conducted among patients with RA referred to a rheumatology center. Health care utilization was assessed for medical care, allied health care, psychosocial care, and home care. The influence of sociodemographic variables and clinical and health characteristics on health care utilization was assessed by means of logistic regression.
  
  
  RESULTS
  Multivariate analyses showed that, for all types of services, disease-related factors explained most of the utilization. However, some sociodemographic variables (age, sex, and living situation) were also related to the utilization of care.
  
  
  CONCLUSIONS
  Most patients received the care they needed. However, for the elderly with RA, problems in access to allied health care and psychosocial care exist.
authors.affiliation: Department of Social Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: C E
authors.initials: CE
authors.lastname: Jacobi
authors.forename: M
authors.initials: M
authors.lastname: Triemstra
authors.forename: I
authors.initials: I
authors.lastname: Rupp
authors.forename: H J
authors.initials: HJ
authors.lastname: Dinant
authors.forename: G A
authors.initials: GA
authors.lastname: Van Den Bos
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy*; D003710:Demography; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012017:Referral and Consultation; D012219:Rheumatology; D012959:Socioeconomic Factors