Emergency Department Visits by Rheumatoid Patients Save

A Canadian population study shows that rheumatoid arthritis (RA) patients have 30% higher emergency department (ED) visit rates for Ambulatory Care Sensitive Conditions (ACSCs) compared to age- and sex-matched population controls.

In 2017, 2.1% of all the ED visits were by RA patients, while prevalence of RA is only 1.1% in Alberta. This study sought to assess the impact of an RA diagnosis on the need for ED visits for any ACSC -conditions that measure adequate primary care and that can be effectively managed by ambulatory outpatient care, thus avoiding complications, more severe disease, ED visits and hospitalizations. Measured ACSC included grand mal seizures, chronic lower respiratory diseases, asthma, diabetes, heart failure and pulmonary edema, hypertension, angina. 

Overall, RA (n=35,770) had higher ED visit rates (for all ACSCs) compared to Non-RA (n=94,094) (adjusted IRR 1.30, 95% CI 1.25, 1.34). 

More than two-thirds of ED visits for ACSCs were triaged as “urgent” or higher severity. 

Over the study period, there was a 34% increase in the proportion of ED visits for an ACSC condition among those with RA.

In the first 5 years of having RA, patients had a 30% higher rate of avoidable ED visits.  Hence there is a significant need for improved ambulatory care access and care quality, from both primary care and subspecialty care physician).