To examine rheumatology subspecialty practice patterns, determinants of referral to rheumatologists, and utilization of aspiration and injection procedures in a population-based sample of elderly individuals.
We obtained Medicare physician claims for all visits to rheumatologists among beneficiaries aged 65 years and older in Colorado, Massachusetts, and Virginia in 1993, and for visits to all providers by patients with coded diagnoses of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).
We examined variations in visit frequency and aspiration/injection procedures, and we analyzed determinants of referral to a rheumatologist for RA or SLE.
In I year, 144,797 visits were made to rheumatologists by 38,443 patients in the three states.
An inflammatory disorder was coded in 45% of visits and a noninflammatory disorder in 50%. Half of patients with RA were seen three or fewer times in the year.
For RA and SLE, African Americans were about 60% as likely to be seen by a rheumatologist as whites.
Utilization of rheumatologist services for rheumatoid arthritis and systemic lupus erythematosus was highest in the state (Virginia) with the lowest per capita supply of rheumatologists.
Among patients with bursitis, tendinitis, and osteoarthritis, African-American women were more likely to receive an injection or aspiration procedure than whites or African-American men. (...)
Mots-clés Pascal : Rhumatologie, Vieillard, Homme, Questionnaire, Articulation, Injection, Aspiration, Noir américain, Etude comparative, Caucasoïde, Utilisation, Système ostéoarticulaire pathologie
Mots-clés Pascal anglais : Rheumatology, Elderly, Human, Questionnaire, Joint, Injection, Aspiration, Black American, Comparative study, Caucasoid, Use, Diseases of the osteoarticular system
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0526486
Code Inist : 002B15D. Création : 23/03/1999.