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Open Access 08-06-2024 | Rheumatoid Arthritis | Cohort Studies

Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study

Authors: Dani G. Contreras, Patrick McLane, Claire E.H. Barber, Katie Lin, Meghan J. Elliott, Kelsey Chomistek, Shanon McQuitty, Eileen Davidson, Clare Hildebrandt, Steven Katz, Eddy Lang, Brian R. Holroyd, Cheryl Barnabe

Published in: Rheumatology International

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Abstract

Some emergency department (ED) visits by persons with rheumatoid arthritis (RA) may be avoidable. This study aims to describe ED use by persons with RA in Alberta, Canada over a 10-year period. Using linked population-based administrative datasets, the annual frequency of ED visits, timing of visits, acuity at presentation assessed (Canadian Triage Acuity Scale (CTAS)), return visits within 72 h, and final disposition were assessed. Most responsible diagnoses assessed by the ED provider were categorized. Between 2008 and 2017, a total of 48,633 persons with RA had 416,964 unique ED visits. There was a 41% relative increase in visits over the study period and within a fiscal year 37% of persons with RA on average attended an ED. Half of the visits were assessed as CTAS 4 ‘Less Urgent’ (31%) and CTAS 5 ‘Non-Urgent’ (19%). No specific diagnosis could be assigned in 36% of visits and RA was listed as the most responsible diagnosis in 2.5% of all visits. Hospital admissions, occurring on average for 14% of ED visits, increased by 15% over the 10 years, and were rare for CTAS 4 (6.4%) and CTAS 5 (1.4%) presentations. Male patients (difference to female 1.2%, 95%CI 0.6, 1.7) and urban patients (difference to rural 8.4%, 95%CI 7.7, 9.2) were more frequently admitted to hospital. Persons with RA have increased ED utilization over time, with a significant volume of less urgent and non-urgent visits. Opportunities for appropriate ambulatory care provision to reduce acute care use should be identified.
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Metadata
Title
Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study
Authors
Dani G. Contreras
Patrick McLane
Claire E.H. Barber
Katie Lin
Meghan J. Elliott
Kelsey Chomistek
Shanon McQuitty
Eileen Davidson
Clare Hildebrandt
Steven Katz
Eddy Lang
Brian R. Holroyd
Cheryl Barnabe
Publication date
08-06-2024
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-024-05627-z
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