title: Variability in the frequency of rheumatology consultations in patients with rheumatoid arthritis in Spain.
abstract: The aim of this work was to assess the variability in the use of health-care resources, based on the number of visits to rheumatology departments by rheumatoid arthritis patients, in Spain, and its association with patient, physician and center characteristics. The sample consisted of patient records of men and women (aged 16 or older), with a clinical diagnosis of RA, who met the American Rheumatism Association 1987 revised criteria and who had been treated in a rheumatology department at a Spanish hospital with at least one visit to a rheumatologist during the two years preceding the date of the study. To analyze which variables were independently associated with the number of consultations, those with a statistically significant result in the bivariate analysis, or which were clinically relevant or deemed confounders, were used in the construction of a linear regression model. The records of 1188 RA patients were studied. The linear regression model explained the 26.67 % of the variability in the number of visits. The number of csDMARDs prescribed, the administration of biological therapy, corticoid prescription, the presence of nursing consultation, mean time to first visit in the department and attended population showed a positive significant association, while the presence of telephone consultation, distance from the hospital to the patient´s residence (≥20 km) and drug monitoring by rheumatology department + primary care physician or by other specialists were negatively associated with the number of consultations. We observed a high variability in the number of visits, which remains partially unexplained even after taking into account individual, physician and center characteristics.
authors.affiliation: Rheumatology Unit, Rheumatology Department, Complejo Hospitalario de Zamora, Avenida Requejo 35, 49022, Zamora, Spain. lopezgonzalezruth@gmail.com.
authors.forename: R
authors.identifier: http://orcid.org/0000-0002-5014-6302
authors.initials: R
authors.lastname: Lopez-Gonzalez
authors.affiliation: Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Seoane-Mato
authors.affiliation: Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Perez-Vicente
authors.affiliation: Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Martin-Martinez
authors.affiliation: Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Sanchez-Alonso
authors.affiliation: Rheumatology Department, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Silva-Fernandez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012219:Rheumatology; D013030:Spain; D055815:Young Adult
keywords: Health-care resources; Rheumatoid arthritis; Variability