Measuring geographic differences in care for rheumatoid arthritis (RA) patients

 

Study title:

Measuring geographic variation in access to care for rheumatoid arthritis (RA) patients: A patient-centred approach

 

Principal Investigator:

Deborah A Marshall, PhD; Professor, Department of Community Health Sciences, Faculty of Medicine,
University of Calgary; Arthur JE Child Chair Rheumatology Research
Claire Barber, MD, PhD; Assistant Professor, Department of Rheumatology, Faculty of Medicine,
University of Calgary

 

Start Date and End Date:

2016 to 2019 (extended)

 

What were the key findings? 

Between April 2015 and March 2016, we found there were 38,350 people living with rheumatoid arthritis (RA), among which 68% were female. The rate of RA in Alberta was 12 people with RA for every 1000 people. Approximately 70% of people with RA lived in urban area such as Calgary, Edmonton, Medicine Hat and Lethbridge. But, the highest rate of RA occurred in the rural areas with 14 people with RA for every 1000 people. Urban areas had a lower rate with 11 people with RA for every 1000 people. Alberta Health Services divided the province into 132 Local Geographic Areas (LGA) to provide detailed information for studies and health service planning. The Rural-Urban Continuum areas, based on the aggregation of LGAs, provide data to plan, monitor, and compare population health by rural-urban status. The areas include seven distinct categories: Metro, Moderate Metro influence, Urban, Moderate Urban influence, Rural Centre, Rural, and Rural Remote. The rates of RA in LGAs ranged from 5 to 31 people with RA for every 1000 people. Seven LGAs in Alberta have statistically significant higher rates of RA than average for the province of Alberta. These areas have rates of RA ranging from 24 to 31 people with RA for every 1000 people and we call ‘hot spots’. Six of these seven ‘hot spots’ are in the Rural and Rural Remote areas. These findings show a significant rural-urban difference in the prevalence of RA.

 

What was done?

Between April 2015 and March 2016, we found there were 38,350 people living with rheumatoid arthritis (RA), among which 68% were female. The rate of RA in Alberta was 12 people with RA for every 1000 people. Approximately 70% of people with RA lived in urban area such as Calgary, Edmonton, Medicine Hat and Lethbridge. But, the highest rate of RA occurred in the rural areas with 14 people with RA for every 1000 people. Urban areas had a lower rate with 11 people with RA for every 1000 people. Alberta Health Services divided the province into 132 Local Geographic Areas (LGA) to provide detailed information for studies and health service planning. The Rural-Urban Continuum areas, based on the aggregation of LGAs, provide data to plan, monitor, and compare population health by rural-urban status. The areas include seven distinct categories: Metro, Moderate Metro influence, Urban, Moderate Urban influence, Rural Centre, Rural, and Rural Remote. The rates of RA in LGAs ranged from 5 to 31 people with RA for every 1000 people. Seven LGAs in Alberta have statistically significant higher rates of RA than average for the province of Alberta. These areas have rates of RA ranging from 24 to 31 people with RA for every 1000 people and we call ‘hot spots’. Six of these seven ‘hot spots’ are in the Rural and Rural Remote areas. These findings show a significant rural-urban difference in the prevalence of RA.

 

Who was involved? 

Co-investigators: Stefania Bertazzon, Alka Patel, Dianne Mosher, Joanne Homik, Steven Katz
Collaborators: Chris Smith and Alberta Bone and Joint Health Institute, Jill Robert and Alberta Health
Services Bone and Joint Health Strategic Clinical Network

 

Funding Agency:

Canadian Initiative for Outcomes in Rheumatology Care (CIORA)

 

Additional Information:

Publications:

Marshall DA, Liu X, Bertazzon S, Patel A B, Mosher D, Homik J, Katz S, Smith C, Robert J, Barber CEH. Geographic variation in the prevalence of rheumatoid arthritis in Alberta: a spatial analysis. CRA annual scientific meeting 2020. Abstract submitted.anuary 2020. Abstract submitted.