The burden of rheumatic disorders in general practice: consultation rates for rheumatic disease and the relationship to age, ethnicity, and small-area deprivation.
OBJECTIVE
To estimate the burden of rheumatic disorders in the New Zealand population by calculating general-practice consultation rates--as well as the influence of age, gender, ethnicity, and small-area deprivation on these consultation rates.


METHODS
Cases were identified from the Royal New Zealand College of General Practitioners database using search-strings of typical words used in consultation notes (for each of 10 rheumatic disorders). Rates were calculated from a denominator of the number of people attending at least once over a 12-month period to any of 22 contributing general practices. The independent effect of age, sex, ethnicity, and small-area deprivation was modelled using multiple logistic regression.


RESULTS
Of 29,152 people attending their general practitioner, 20.4% consulted with a rheumatic disorder. Older people, males, people who lived in more deprived areas, and Europeans were more likely to consult with a rheumatic disorder. With all rheumatic disorders, age was a significant influence upon consultation--especially osteoarthritis, gout, osteoporosis, and joint surgery. Maori were more likely than Europeans to consult with gout, but they were slightly less likely to consult with back pain or regional pain disorders. Small-area deprivation had small influences upon people consulting with gout, regional pain, and back pain.


CONCLUSIONS
Rheumatic disorders form a significant part of the workload of general practitioners and this is significantly influenced by local demographic factors. Most of these conditions seen in general practice are non-inflammatory and non-surgical. If a community-needs approach was taken, it is likely that the workload and associated costs would be even greater.
Rehabilitation Teaching and Research Unit, Department of Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. wtaylor@wnmeds.ac.nz
William
W
Taylor
Louis
L
Smeets
Jason
J
Hall
Kathryn
K
McPherson
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000208:ethnology; D012737:Sex Factors; D017062:Small-Area Analysis; D012959:Socioeconomic Factors