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Rheumatology out-patient workload increases inexorably
1University Division of Medicine, Bristol Royal Infirmary.
British Journal of Rheumatology
|April 1, 1997
Summary
Rheumatology outpatient referrals increased significantly, leading to longer waiting times for new patients. The proportion of non-arthritic conditions seen in rheumatology clinics also rose.
Area of Science:
- Rheumatology
- Health Services Research
Background:
- Rheumatology outpatient services in South-West England have experienced changes in patient volume and referral patterns.
- Historical data from 1988 to 1992 provide a baseline for comparison with recent trends.
Purpose of the Study:
- To analyze trends in rheumatology outpatient consultations, including patient numbers, waiting times, and diagnostic categories.
- To assess the impact of National Health Service reforms on rheumatology referral rates and workload.
Main Methods:
- Retrospective analysis of rheumatology outpatient consultation data from November 1994.
- Comparison with historical data from 1988, 1990, 1991, and 1992.
- Inclusion of detailed information from one center's historical records.
Main Results:
- A 31% overall increase in patients seen, with a 36% rise in new referrals.
- Mean waiting time for new patient consultations increased from 65 to 108 days.
- Increase in non-arthritic diseases (8.2%) and decrease in rheumatoid arthritis and polyarthritis (9.0%) among new referrals.
Conclusions:
- Referral rates have outpaced the capacity to manage increased workload since the introduction of National Health Service reforms.
- The rising demand and changing case-mix in rheumatology outpatient services necessitate service re-evaluation and resource allocation.
- Increased waiting times for new patients indicate potential delays in diagnosis and treatment initiation for rheumatological conditions.