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Does everybody need a team?

Theodora P M Vliet Vlieland¹, Linda C Li, Crystal MacKay

¹Leiden University Medical Center, Department of Rheumatology, Leiden, The Netherlands. t.p.m.vliet_vlieland@lumc.nl

The Journal of Rheumatology

|September 9, 2006

Summary

Multidisciplinary team care for arthritis is effective, but a clinical nurse specialist can achieve similar results for rheumatoid arthritis (RA) patients at lower costs, suggesting provider skills are key.

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Area of Science:

Rheumatology
Healthcare Management
Clinical Nursing

Background:

Multidisciplinary team care has been a standard in arthritis management since the 1950s.
Its effectiveness is primarily established in rheumatoid arthritis (RA) patients compared to regular outpatient care.
However, traditional models may not always be accessible or suitable.

Purpose of the Study:

To evaluate the effectiveness of alternative care models in arthritis management.
To identify the core components of successful multidisciplinary team care.
To explore cost-effective alternatives for patients with unmet healthcare needs.

Main Methods:

Comparison of multidisciplinary team care with regular outpatient care for RA patients.
Analysis of outcomes achieved by clinical nurse specialists versus traditional multidisciplinary teams.
Assessment of the impact of provider skills and service coordination.

Main Results:

Similar positive outcomes in RA patients can be achieved by clinical nurse specialists.
Care provided by a clinical nurse specialist may be more cost-effective.
The number of professionals or their proximity may be less critical than provider expertise and coordination.

Conclusions:

The key components of effective arthritis care may lie in provider rheumatology skills and service coordination, not solely the multidisciplinary team structure.
Clinical nurse specialists can offer a viable, potentially more affordable alternative for RA management.
Development and evaluation of alternative comprehensive care models are recommended for arthritis patients with complex needs.

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