Project 456742

Rheumatology is the medical specialty dedicated to providing healthcare to persons who have autoimmune inflammatory arthritis conditions, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA). Based on overwhelming evidence that early diagnosis and aggressive treatment in the first phases of these inflammatory arthritis conditions prevents or minimizes permanent joint damage and disability, systems that prioritize appointments for new patients were put into place. This has displaced the care of patients who are in later phases of their inflammatory arthritis conditions, and they experience difficulty in getting appointments for urgent concerns. This leads to a trickle-down effect on emergency departments, urgent care centres and hospitals, as either the established arthritis patient's condition worsens and they become more ill, requiring a visit to the emergency department, or because they don't have any other choice of where to seek care. This research project will use provincial healthcare data to study patterns of acute care use by patients with inflammatory arthritis conditions, and specifically examine if there are groups of arthritis patients who need to use the emergency department, urgent care centres or hospitals more than others, reflecting difficulties they have in accessing rheumatology and primary care. We will conduct interviews and hold focus groups with patients with inflammatory arthritis conditions to understand why they chose to use an emergency department, and identify what outpatient care access would have helped to avoid visits for non-emergent concerns. We will work in collaboration with rheumatologists, emergency medicine physicians, primary care doctors, patients and healthcare leaders to create a care system that can address urgent medical concerns that persons with inflammatory arthritis conditions experience to avoid emergency department and hospital use.