Open AccessAmbulatory visit utilization in a national, population‐based sample of adults with osteoarthritis
Author(s) -
Cisternas Miriam G.,
Yelin Edward,
Katz Jeffrey N.,
Solomon Daniel H.,
Wright Elizabeth A.,
Losina Elena
Publication year - 2009
Publication title -
arthritis care & research
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.24897
Subject(s) - medicine , osteoarthritis , population , logistic regression , physical therapy , ambulatory , family medicine , health care , gerontology , alternative medicine , environmental health , pathology , economics , economic growth
Abstract Objective To estimate the proportion of adults with osteoarthritis (OA) seeing various medical providers and ascertain factors affecting the likelihood of a patient seeing an OA specialist. Methods We used data from the Medical Expenditures Panel Survey, a stratified random sample of the noninstitutionalized civilian population. We classified adults as having symptomatic OA if their medical conditions included at least 1 occurrence of the International Classification of Diseases, Ninth Revision Clinical Modification, codes 715, 716, or 719, and if they reported joint pain, swelling, or stiffness during the previous 12 months. For the purpose of our analysis, we defined rheumatologists, orthopedists, and physical therapists as OA specialists. We first estimated the proportion of OA individuals seen by OA specialists and other health care providers in a 1‐year period. We then used logistic regression to estimate the impact of demographic and clinical factors on the likelihood of an individual seeing an OA specialist. Results A total of 9,933 persons met the definition of OA, representing 22.5 million adults in the US. Of these persons, 92% see physicians during the year, 34% see at least 1 OA specialist, 25% see an orthopedist, 11% see a physical therapist, and 6% see a rheumatologist. Higher educational attainment, having more comorbidities, and residing in the northeastern US are significant positive predictors for a patient seeing an OA specialist. Significant negative predictors for seeing an OA specialist are being unmarried but previously married and having no health insurance. Conclusion Most adults with OA do not visit OA specialists. Those without insurance and with lower levels of education are less likely to see these specialists.