Division of Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pediatric Rheumatology, Boys Town National Research Hospital, Omaha, NE, 68010, USA.
Pediatr Rheumatol Online J. 2023 Oct 13;21(1):120. doi: 10.1186/s12969-023-00910-y.
Pediatric rheumatology faces a looming supply-demand crisis. While strategies have been proposed to address the supply shortfall, investigation into the increased demand for pediatric rheumatic care has been limited. Herein, we analyze new patient visits to a large tertiary care pediatric rheumatology center to identify emerging trends in referrals and areas for potential intervention to meet this increased demand.
All patients referred to and seen by the University of Alabama at Birmingham Pediatric Rheumatology Division between January 2019 and December 2021 for a new patient evaluation were identified. Patient data was retrospectively abstracted, de-identified, and analyzed to develop trends in referrals and frequency of rheumatic disease, non-rheumatic disease, and specific diagnoses.
During the study period, 2638 patients were referred to and seen in by the pediatric rheumatology division. Six hundred and ten patients (23.1%) were diagnosed with rheumatic disease. The most common rheumatic disease was juvenile idiopathic arthritis (JIA) at 45.6%, followed by primary Raynaud phenomenon (7.4%), recurrent fever syndromes (6.9%), vasculitides (6.7%), and inflammatory eye disease (6.2%). Of the 2028 patients (76.9%) diagnosed with a non-rheumatic condition, benign musculoskeletal pain was the most common (61.8%), followed by a combination of somatic conditions (11.6%), and non-inflammatory rash (7.7%).
In this analysis of new patient referrals to a large pediatric rheumatology center, the majority of patients were diagnosed with a non-rheumatic condition. As a worsening supply-demand gap threatens the field of pediatric rheumatology, increased emphasis should be placed on reducing non-rheumatic disease referrals.
儿科风湿病面临着迫在眉睫的供需危机。虽然已经提出了一些策略来解决供应短缺问题，但对儿科风湿病需求增加的调查却有限。在此，我们分析了一家大型三级儿童风湿病中心的新患者就诊情况，以确定转诊的新趋势和潜在干预领域，以满足这种需求的增加。
确定了 2019 年 1 月至 2021 年 12 月期间，因新患者评估而转至阿拉巴马大学伯明翰分校儿科风湿病科并接受诊治的所有患者。回顾性提取、去识别患者数据，并进行分析，以确定转诊和风湿性疾病、非风湿性疾病以及特定诊断的频率趋势。
在研究期间，有 2638 名患者被转至儿科风湿病科并接受诊治。610 名患者（23.1%）被诊断为风湿性疾病。最常见的风湿性疾病是幼年特发性关节炎（JIA），占 45.6%，其次是原发性雷诺现象（7.4%）、复发性发热综合征（6.9%）、血管炎（6.7%）和炎症性眼病（6.2%）。在 2028 名被诊断为非风湿性疾病的患者中（76.9%），良性肌肉骨骼疼痛最常见（61.8%），其次是躯体疾病组合（11.6%）和非炎症性皮疹（7.7%）。
在对一家大型儿科风湿病中心的新患者转诊进行的这项分析中，大多数患者被诊断为非风湿性疾病。随着儿科风湿病领域供需差距的恶化，应更加重视减少非风湿性疾病的转诊。
