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Profile of a pediatric rheumatology practice in Israel
1Pediatric Rheumatology Service, Sieff Hospital, Safed and Poriya Hospital, Tiberias, Israel. hashkep@ccf.org
Insights
Pediatric rheumatology practices in Israel see many non-inflammatory conditions and a high rate of periodic fever syndromes, which are challenging for primary care physicians to diagnose.
Area of Science:
- Pediatric Rheumatology
- Clinical Practice Analysis
- Epidemiology
Background:
- Western studies characterize pediatric rheumatology practices.
- Demographic and healthcare variations may alter practice profiles in Israel.
- Understanding Israel's pediatric rheumatology practice is essential.
Purpose of the Study:
- To delineate the characteristics of a pediatric rheumatology practice in Israel.
- To analyze patient demographics, referral patterns, and diagnoses.
- To establish a baseline for pediatric rheumatology in the region.
Main Methods:
- Prospective registration of new patients in a Northern Israel pediatric rheumatology practice during 2000.
- Collection of demographic data, referral sources, and diagnoses.
- Categorization of diagnoses into distinct condition types.
Main Results:
- 242 new patients evaluated; 39% had rheumatic conditions, 39% non-inflammatory, 12% periodic fever syndromes.
- Periodic fever syndromes showed longer diagnosis times and more physician involvement.
- Juvenile rheumatoid arthritis (JRA) incidence estimated at 8.8 per 100,000 children.
Conclusions:
- Pediatric rheumatology practice in Israel mirrors Western data with many non-inflammatory conditions.
- Periodic fever syndromes represent a significant portion of practice, unique to the region.
- These syndromes pose diagnostic challenges for community physicians.
Background:
Several studies from Western countries have analyzed the profile of pediatric rheumatology practices. Due to differences in demography and health care systems the profile in Israel may differ from those countries.
Objective:
To describe the profile of a pediatric rheumatology practice in Israel.
Methods:
All new patients seen during the course of 2000 as part of my pediatric rheumatology practice in Northern Israel were registered at their initial encounter. Recorded were demographic data, referral patterns, diagnoses, and disease-related data. Diagnoses were grouped together by types of condition.
Results:
242 new patients were seen. 39% of the patients had a rheumatic condition, 39% had non-inflammatory conditions, 12% had periodic fever syndromes and for 10% no definitive diagnosis was determined. 14% had chronic rheumatic diseases. The time until diagnosis was significantly greater and more physicians were involved in the evaluation of periodic fever syndromes than in other disease groups. Seventeen (7%) patients had juvenile rheumatoid arthritis (JRA). The minimum estimated incidence of JRA was 8.8 per 100,000 children.
Conclusions:
Most patients seen did not have classic inflammatory rheumatic diseases, similar to data from other Western countries. Distinctive to Israel and the Middle East, periodic fever syndromes comprise a large proportion of the pediatric rheumatology practice. These syndromes are relatively difficult for community physicians to diagnose.