ED Utilization by Psoriatic and Spondyloarthritis Patients Save

A cohort analysis of ambulatory emergency department (ED) utilization by patients with psoriatic arthritis (PsA) and radiographic axial spondyloarthritis (r-axSpA) demonstrated significant use for less urgent and nonurgent health issues, particularly in rural settings.

A study of administrative datasets from Alberta, Canada (2007-2018) assessed ED visit frequency, timing, triage acuity, diagnoses, and disposition for PsA and r-axSpA patients.

The study examined 4984 PsA and 14,690 r-axSpA patients (with 53,174 and 124,037 ED encounters).  Overall, an average of 48% of PsA and 36% of r-axSpA accessed the ED annually. 

Less urgent or nonurgent ED visits were common, comprising 44% and 50% of visits, respectively. Infection and injury were the most common diagnoses.  Presentations for inflammatory arthritis were infrequent (1.2% and 2%). 

Rural patients were twice as likely to visit the ED, with a higher frequency of less acute presentations, and were admitted less often in both disease cohorts. 

Female patients with PsA had a lower frequency of admissions relative to male patients with PsA.

Such data suggest a need for better education and healthcare reform to provide effective, but tailored health service delivery amongst spondyloarthritis patients, especially in rural areas.