The following is a summary of “Effects of Continuity of Rheumatology Care on Emergency Department Utilization and Hospitalizations for Individuals With Early Rheumatoid Arthritis: A Population-Based Study,” published in the June 2023 issue of Rheumatology by Davtyan et al.

This study aims to ascertain whether continuity of rheumatology care influences emergency department (ED) visits and hospitalization rates among patients with rheumatoid arthritis (RA). A closed cohort of patients diagnosed with rheumatoid arthritis between 2000 and 2009 was observed until December 31, 2019. Researchers classified patients into three rheumatology care continuity groups (high, intermediate, and not retained in rheumatology care) during the first five years after diagnosis. 

They compared the rates of ED visits and hospitalizations during the follow-up period using a landmark analysis. Using multivariable Poisson regression models, adjusted for demographics, comorbidities, and health services access and supply measures, rate ratios (RRs) were estimated. The cohort comprised 38,528 patients, of whom 57.7% (n = 22,221) were classified as belonging to the high rheumatology continuity group, 17.2% (n = 6,636) to the intermediate group, and 25.1% (n = 9671) to the group not retained in rheumatology care. The intermediate and non-retention groups had higher ED rates than the high continuity group (RR 1.14, 95% CI 1.08-1.20 and RR 1.12, 95% CI 1.08-1.16, respectively). 

The intermediate group also had higher adjusted hospitalization rates than the high continuity group (207.4, 95% CI 203.0-211.8 per 1,000 person-years [PY] vs. 193.5, 95% CI 191.4-195.6 per 1000 PY). During the first 5 years of follow-up, patients with RA who received more excellent continuity of rheumatology care had lower ED visits and hospitalization rates than those who did not receive continuous rheumatology care. These findings prove that early and continuous rheumatology care reduces hospitalizations and emergency department visits.

Source: jrheum.org/content/50/6/748