Consultation with an arthritis specialist for children with suspected juvenile rheumatoid arthritis: a population-based study.
OBJECTIVE
To describe consultation with an arthritis specialist because of suspected new-onset juvenile rheumatoid arthritis (JRA) and to determine factors associated with prompt consultation.


METHODS
Retrospective cohort study.


METHODS
Physician reimbursement administrative data were obtained for all children aged 16 years or younger in the Province of Québec (Canada).


METHODS
Suspected new-onset cases of JRA in 2000 were defined by a physician visit because of JRA, providing there had been no such claims in the preceding 3 years.


METHODS
First JRA diagnosis made by a non-arthritis specialist.


METHODS
First consultation with an arthritis specialist subsequent to diagnosis by a non-arthritis specialist and time to first consultation with an arthritis specialist.


RESULTS
Of 352 children and adolescents with suspected new-onset JRA identified by non-arthritis specialists, 159 (45.2%) were subsequently seen by an arthritis specialist. Mean (SD) time to consultation for those seen was 115.3 (213.8) days (median, 28 days). Younger children were more likely to obtain care from an arthritis specialist compared with those having JRA first diagnosed by a general practitioner.


CONCLUSIONS
Most patients with suspected new-onset JRA do not obtain prompt care from an arthritis specialist. Further research and action should focus on this issue so that outcomes may be optimized.
Ehrmann Feldman
Debbie
D
Faculté de Médecine, Ecole de Réadaptation, Université de Montréal, CP 6128, Succursale Centre-ville, Montréal, QC H3C 3J7, Canada. Debbie.feldman@umontreal.ca
Bernatsky
Sasha
S
Abrahamowicz
Michal
M
Roy
Yves
Y
Xiao
Yongling
Y
Haggerty
Jeannie
J
Leffondré
Karen
K
Tousignant
Pierre
P
Duffy
Ciarán M
CM
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D002648:Child; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D011792:Quebec / Q000453:epidemiology; D012017:Referral and Consultation; D012189:Retrospective Studies; D012219:Rheumatology; D000078329:Workforce