New models of care for patients with rheumatoid arthritis.
Traditional comprehensive care, involving a team of health professionals from various disciplines, has been widely used in patients with rheumatoid arthritis. However, in many countries, its access and use are hindered by limitations in human and financial resources. Moreover, due to developments in the medical treatment of rheumatoid arthritis and in healthcare and society in general, the patients' needs and demands regarding the contents and organization of comprehensive care are changing. To guarantee the provision of care meeting the varying requirements of rheumatoid arthritis patients throughout the disease trajectory, several new care models are being developed. Some of these models include nurses or other health professionals and general practitioners in care pathways and processes. In other models, organizational aspects play a major role, such as new ways of running early arthritis and direct-access clinics. In addition, an optimal use of information technology may prove to be an important step forward. With all of these developments, aspects such as the patients', as well as healthcare providers', educational needs, continuity, access and funding have to be taken into account. Moreover, evaluations of effectiveness and costs in various healthcare systems and local organizations are needed.
Vliet Vlieland
Theodora Pm
TP
Associate Professor, Leiden University Medical Center, Department of Rheumatology, C1-RPO Box 9600, 2300 RC Leiden, The Netherlands. t.p.m.vliet_vlieland@lumc.nl.