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Demographic and Clinical Factors Associated with Physician Service Use in Systemic Sclerosis SASHA BERNATSKY, PANTELIS PANOPOLIS, MARIE HUDSON, JANET POPE, SHARON LECLERCQ, DAVID ROBINSON, NIALL JONES, JANET MARKLAND, MAYSAN ABU-HAKIMA, JEAN-PIERRE MATHIEU, PETER DOCHERTY, NADER KHALIDI, EVELYN SUTTON, MURRAY BARON, and the Canadian Scleroderma Research Group
ABSTRACT. Methods. Our sample was a national SSc registry maintaining data on demographics (age, sex, race/ethnicity, education, income) and clinical factors (disease onset, organ involvement, etc.). Registry cohort members completed detailed questionnaires, and rheumatologists provided clinical assessments. We examined cross-sectional data from 397 patients who provided information on physician visits in the past 12 months. Patients were classified as high physician-users if they reported more than the median number (6) of physician visits in the past year. In multivariate logistic regressions, we assessed the independent effects of race/ethnicity, education, degree of skin involvement, comorbidity, and SF-36 scores on physician use. Results. On average, subjects reported 3.8 visits per year to specialty physicians (SD 4.2) and 3.5 visits per year to family physicians (SD 4.3). Regression models suggested the following factors as independently associated with number of physician visits: high skin scores, greater comorbidity, and low physical component summary scores on the SF-36. Conclusion. There is evidence of independent relationships between clinical characteristics and physician use by patients with SSc. (J Rheumatol First Release Nov 15 2008; doi:10.3899 /jrheum.080623) Key Indexing Terms:
SYSTEMIC SCLEROSIS
From McGill University, Montreal, Quebec, Canada; University of California, San Francisco, California, USA; University of Western Ontario, London, Ontario; University of Calgary, Calgary, Alberta; University of Manitoba, Winnipeg, Manitoba; University of Alberta, Edmonton, Alberta; University of Saskatchewan, Regina, Saskatchewan; University of Montreal, Montreal, Quebec; Dalhousie University, Halifax, Nova Scotia; and McMaster University, Hamilton, Ontario, Canada. Dr. Bernatsky is a Canadian Arthritis Network (CAN) scholar and is supported by the Canadian Institutes of Health Research (CIHR), Fonds de recherche en santé du Québec (FRSQ), and the McGill University Health Centre (MUHC) Department of Medicine and Research Institute. Dr. Hudson is a CAN scholar and is supported by the CIHR. Dr. Baron is the director of the Canadian Scleroderma Research Group, which is supported by research grants from the CIHR, the Cure Scleroderma Foundation, the Scleroderma Society of Canada, and the Ontario Arthritis Society, as well as educational grants from Actelion Pharmaceuticals, Pfizer Incorporated and Encysive Pharmaceuticals. S. Bernatsky, MD; M. Hudson, MD; M. Baron, MD, McGill University; P. Panopolis, MD, University of California, San Francisco; J. Pope, MD, University of Western Ontario; S. LeClercq, MD, University of Calgary; D. Robinson, MD, University of Manitoba; N. Jones, MD, University of Alberta; J. Markland, MD, University of Saskatchewan; M. Abu-Hakima, MD, University of Calgary; J-P. Mathieu, MD, University of Montreal; P. Docherty, MD, Dalhousie University; N. Khalidi, MD, McMaster University; E. Sutton, MD, Dalhousie University. Address reprint requests to Dr. S. Bernatsky, Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, 687 Pine Avenue West, V-Building, Montreal, Quebec H3A 1A1. E-mail: sasha.bernatsky@mail.mcgill.ca Accepted for publication August 18, 2008.
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