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  1. The short-term health outcome of out-patient rheumatology consultations in relation to rationing : A pilot study.

    Article - En anglais

    The objectives were to test whether the short-term health outcome of rheumatology out-patients differs according to clinical priority.

    The setting was an NHS regional rheumatology out-patient department serving a catchment population of over 1 million.

    The subjects were 249 consecutive rheumatology out-patients categorized on the basis of the referral letter as'urgent' (n=50), soon' (n=100) or'routine' (n=99).

    Primary outcome measures were the proportion of patients reporting improvement in health categorized by clinical priority (urgent, soon or routine) or main diagnostic group (inflammatory or non-inflammatory disease).

    Secondary outcome was change in health status measured using the EuroQol generic health instrument (EQ-5D).

    Small but insignificant differences in the proportion of patients reporting health improvement were found between the urgent (28%), soon (23%) and routine (17%) categories (Kruskal-Wallis, P=0.186).

    Thirty per cent of patients with inflammatory joint disease reported improvement compared with 17% of those with non-inflammatory conditions (Mann-Whitney U, P=0.019).

    In patients reporting improvement, the median (interquartile range) improvement in EQ-5D health utility score was+0.2 (0.58) (P=0.0001) and that of visual analogue health score was+5 (16) (P=0.001).

    Clinical priority setting, by giving priority to some patients over others, results in rationing by delay. (...)

    Mots-clés Pascal : Rhumatologie, Symptomatologie, Malade, Ambulatoire, Audit, Analyse quantitative, Pronostic, Court terme, Politique sanitaire, Epidémiologie, Homme

    Mots-clés Pascal anglais : Rheumatology, Symptomatology, Patient, Ambulatory, Audit, Quantitative analysis, Prognosis, Short term, Health policy, Epidemiology, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0286827

    Code Inist : 002B15I. Création : 27/11/1998.