A Population-Based Approach to Reporting System-Level Performance Measures for Rheumatoid Arthritis Care
Related Experiment Video
Updated: Dec 26, 2025
Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
Claire E H Barber1, Deborah A Marshall1, Elena Szefer2
1University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada.
Insights
This study operationalized rheumatoid arthritis (RA) performance measures using health data in British Columbia. It found improvements in timely specialist care but suboptimal disease-modifying antirheumatic drug (DMARD) use, highlighting areas for improved RA management.
Area of Science:
- Rheumatology
- Health Services Research
- Public Health
Background:
- Rheumatoid arthritis (RA) management requires adherence to evidence-based performance measures (PMs) for optimal patient outcomes.
- Health administrative data offers a valuable resource for monitoring RA care delivery on a population level.
- Nationally endorsed PMs provide benchmarks for assessing and improving the quality of RA care.
Purpose of the Study:
- To operationalize and report on nationally endorsed rheumatoid arthritis (RA) performance measures (PMs) using health administrative data in British Columbia (BC), Canada.
- To assess the quality of RA care delivery by examining key performance indicators.
- To identify gaps in RA care and inform quality improvement initiatives.
Main Methods:
- A retrospective cohort study utilizing health administrative data from British Columbia (BC), Canada.
- Identification of incident and prevalent rheumatoid arthritis (RA) cases aged 18 years and older between 1997 and 2009, with follow-up until 2014.
- Analysis of performance measures including rheumatologist visit frequency, disease-modifying antirheumatic drug (DMARD) dispensing, and time to DMARD initiation.
Main Results:
- The percentage of RA patients receiving timely rheumatologist care within 365 days increased from 35% in 2000 to 65% in 2009.
- The proportion of RA patients seen annually by a rheumatologist declined from 79% in 2001 to 39% in 2014.
- Disease-modifying antirheumatic drug (DMARD) dispensing was suboptimal in the total RA population (37% in 2014), but higher (87%) in patients under current rheumatologist care.
Conclusions:
- Operationalizing national performance measures (PMs) using administrative data is feasible for monitoring RA care quality.
- While access to rheumatologists has improved, significant gaps remain in timely disease-modifying antirheumatic drug (DMARD) initiation and ongoing management.
- These findings underscore the need for targeted interventions to address suboptimal RA care and improve patient outcomes.
Objective:
To operationalize and report on nationally endorsed rheumatoid arthritis (RA) performance measures (PMs) using health administrative data for British Columbia (BC), Canada.
Methods:
All patients with RA in BC ages ≥18 years were identified between January 1, 1997 and December 31, 2009 using health administrative data and followed until December 2014. PMs tested include: the percentage of incident patients with ≥1 rheumatologist visit within 365 days; the percentage of prevalent patients with ≥1 rheumatologist visit per year; the percentage of prevalent patients dispensed disease-modifying antirheumatic drug (DMARD) therapy; and time from RA diagnosis to DMARD therapy. Measures were reported on patients seen by rheumatologists, and in the total population.
Results:
The cohort included 38,673 incident and 57,922 prevalent RA cases. The percentage of patients seen by a rheumatologist within 365 days increased over time (35% in 2000 to 65% in 2009), while the percentage of RA patients under the care of a rheumatologist seen yearly declined (79% in 2001 to 39% in 2014). The decline was due to decreasing visit rates with increasing follow-up time rather than calendar effect. The percentage of RA patients dispensed a DMARD was suboptimal over follow-up (37% in 2014) in the total population but higher (87%) in those under current rheumatologist care. The median time to DMARD in those seen by a rheumatologist improved from 49 days in 2000 to 23 days in 2009, with 34% receiving treatment within the 14-day benchmark.
Conclusion:
This study describes the operationalization and reporting of national PMs using administrative data and identifies gaps in care to further examine and address.
More Related Videos
Related Concept Videos
01:20Rheumatic Heart Disease IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:11Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:24Data Reporting and Recording