Nair B V, Schuler R, Stewart S, Taylor-Gjevre R M
Division of Rheumatology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Musculoskeletal Care. 2016 Dec;14(4):243-251. doi: 10.1002/msc.1146. Epub 2016 May 3.
The aim of the present study was to identify potential barriers for access to medical and allied health services from the perspective of rural and Northern Saskatchewan rheumatoid arthritis (RA) patients.
A total of 100 adults with established RA, residing in rural and Northern Saskatchewan, were recruited from two rheumatology practices. Structured interviews with standardized scripts solicited patient perspectives on appointment waiting times, travel required to access medical services and satisfaction with healthcare provision. Thematic analysis was employed for qualitative data.
Patients-reported concerns regarding waiting time for their first rheumatology appointment. There was reduced access to allied health professionals, with only 53% of the participants having seen a physiotherapist (PT), and only 26% an occupational therapist (OT). Patients had similar driving distances to their family physician, PT, pharmacy and laboratory services but commuted significantly further for rheumatologist and OT services. There were high levels of satisfaction with their rheumatologist and family physician appointments (8.96 and 8.04 on a ten-point scale). Patients with longer travel times had higher satisfaction with their health care appointments: Patients who travelled one, two and more than two hours had satisfaction scores of 0.93, 0.88 and 1.32 points higher on a ten-point scale (p < 0.03).
Access to medical services is a concern for this population. Patients were dissatisfied with the waiting time for their first specialist appointment and with decreased access to allied health professionals. Patients travelling longer distances were more satisfied with their health care provider's care, suggesting that good patient-care giver relationships helped to ameliorate the difficulties of travelling to their appointments. Copyright © 2016 John Wiley & Sons, Ltd.
本研究旨在从萨斯喀彻温省农村和北部类风湿性关节炎（RA）患者的角度，确定获得医疗及相关健康服务的潜在障碍。
从两家风湿病诊所招募了100名居住在萨斯喀彻温省农村和北部的确诊RA成年患者。采用标准化脚本进行结构化访谈，征求患者对预约等待时间、获得医疗服务所需行程以及对医疗服务满意度的看法。对定性数据进行主题分析。
患者报告了对首次风湿病预约等待时间的担忧。获得相关健康专业人员服务的机会减少，只有53%的参与者看过物理治疗师（PT），只有26%看过职业治疗师（OT）。患者到家庭医生、PT、药房和实验室服务的驾车距离相似，但到风湿病医生和OT服务的通勤距离明显更远。患者对风湿病医生和家庭医生的预约满意度较高（十分制下分别为8.96和8.04）。行程时间较长的患者对医疗预约的满意度更高：行程一小时、两小时及两小时以上的患者在十分制下的满意度得分分别高出0.93、0.88和1.32分（p<0.03）。
获得医疗服务是这一人群关心的问题。患者对首次专科预约的等待时间以及获得相关健康专业人员服务的机会减少感到不满。行程距离较长的患者对医疗服务提供者的护理更满意，这表明良好的医患关系有助于缓解就医行程中的困难。版权所有©2016约翰威立父子有限公司。
