title: A retrospective review of rheumatology referral wait times within a health centre in Quebec, Canada.
abstract: It is important that inflammatory arthropathies such as rheumatoid arthritis be diagnosed promptly so that treatment can be administered in a timely fashion. However, there is considerable evidence that this process of care is delayed in many people. The aim of the study is to assess wait times between primary care referral and rheumatology assessment for new-onset inflammatory arthropathies. We performed a retrospective review related to new rheumatology consultations (N = 202) between September and November 2008 within the McGill University Health Centre, Montreal, Canada. At this centre, no formal triaging of rheumatology referrals exists. Of the 202 charts reviewed, wait times could be calculated in 164 cases. Only consultations for new-onset conditions were analyzed (N = 161). The results showed that patients with inflammatory arthritis were seen approximately 34.6 days (median 26) post-referral. Wait times for individuals who were ultimately diagnosed with non-urgent conditions (osteoarthritis, fibromyalgia and soft-tissue rheumatism) averaged 41.0 days (median 29). In conclusions, compared to non-urgent cases, individuals with inflammatory arthritis were seen about 1 week sooner. Nevertheless, provisional diagnosis provided on referrals did not appear to expedite wait times for persons with suspected inflammatory arthritis. This suggested that other factors, such as the concern of the patient, may have an influence on referral wait times. Implementation of a rapid access program or triage system may be helpful to further decrease wait times for inflammatory arthropathies.
authors.affiliation: Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, V-Building, Room V2.09, Montreal, QC, Canada. junyi.qian@mail.mcgill.ca
authors.forename: Junyi
authors.initials: J
authors.lastname: Qian
authors.forename: D
authors.initials: D
authors.lastname: Ehrmann Feldman
authors.forename: Asvina
authors.initials: A
authors.lastname: Bissonauth
authors.forename: Henri-André
authors.initials: HA
authors.lastname: Ménard
authors.forename: Pantelis
authors.initials: P
authors.lastname: Panopalis
authors.forename: Michael
authors.initials: M
authors.lastname: Stein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lee
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D009937:Organizational Objectives; D011792:Quebec; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000628:therapy; D012219:Rheumatology / Q000458:organization & administration / Q000706:statistics & numerical data*; D013997:Time Factors; D014850:Waiting Lists