Research Ongoing

Use of the Emergency Department by Persons with Inflammatory Arthritis Conditions

Scientific Study Title:

Acute Care Use by Patients with Inflammatory Arthritis Conditions: Health System Impact and Solutions for Ensuring Appropriate Ambulatory Care Access

Start Date:

March 2022

End Date:

February 2023

Research Category

Arthritis Care, Health Habits & Wellbeing, Health Systems, Policies & Economics

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Why do this research?

Reason For Research

We did this research to find out why people with long-term inflammatory arthritis go to the emergency department when they need more care. There are certainly symptoms or conditions where it is appropriate to go to the emergency department, such as for a heart attack or a broken bone. However, sometimes people go to the emergency department because they can’t get an appointment with their family doctor or rheumatologist for a non-emergency concern in a timely manner. Many of these visits might be avoidable, so by better understanding these visits, we hope to find ways to improve care and reduce unnecessary emergency department use.

Methodology

Execution of Research

We looked at Alberta healthcare data over several years to see how often people with inflammatory forms of arthritis used the emergency department, and why. We wanted to know about the frequency, timing, and reasons for emergency department visits, and the type of care patients received. Specifically, we:

Used administrative healthcare records to track the frequency of emergency department visits, the urgency of visits, and whether people were admitted to the hospital.
Used survey responses collected directly from patients with inflammatory arthritis to learn more about their reasons for visiting the emergency department, and their experiences with healthcare.

Findings & Next Steps

We found that people with inflammatory arthritis go to the emergency department for reasons such as arthritis flare-ups, chest pain, infections, or injuries, and that some of these visits could be avoided with better outpatient care. Some patients reported that they often tried to get care elsewhere first, like with their rheumatologist or family doctor, but health system challenges pushed them to go to the emergency department instead. Rural patients visited the emergency department more often and faced more challenges in getting timely care. A lot of people didn’t follow up with a rheumatologist after their emergency department visit, and many weren’t even referred for any form of follow-up.

What is the Impact?

This study shows us that by improving access to regular arthritis care and better coordinating between different parts of the healthcare system, we could reduce unnecessary emergency department visits and make care more efficient and less disruptive for patients with inflammatory arthritis.

Related Publications

Contreras DG, McLane P, Barber CEH, et al. Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study. Rheumatol Int. 2024;44(9):1691-1700. doi:10.1007/s00296-024-05627-z
Mocanu V, Barber CEH, McLane P, et al. Potentially Avoidable Emergency Department Utilization by Persons with Psoriatic Arthritis and Ankylosing Spondylitis: A Population-Based Cohort Study. Journal of rheumatology. Published online 2025. doi:10.3899/jrheum.2024-1113
Pianarosa E, Roach P, Barber CEH, et al. Deciding to Attend the Emergency Department: Experiences of Patients With Inflammatory Arthritis. Journal of rheumatology. 2024;51(10):jrheum.2024-0111-. doi:10.3899/jrheum.2024-0111

Learn more by viewing our study infographic.

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