Jiang Yuxuan, Rudin Robert S, Santacroce Leah M, Collins Jamie E, Stratton Jackie, Altwies Hallie, Solomon Daniel H
Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
RAND Corporation, Boston, MA, USA.
Rheumatol Ther. 2025 May 8. doi: 10.1007/s40744-025-00768-4.
INTRODUCTION: This study aimed to describe outpatient visit volume in a subspecialty clinic before, during, and after COVID lockdown. METHODS: We assessed monthly in-person and virtual visit volume (telephone-only or video) of 257 patients with rheumatoid arthritis (RA) at one academic center before, during, and post COVID lockdown, November 2018 to September 2021. The primary outcome was monthly visit volume to a rheumatologist. Visit volume, visit type (in-person vs. virtual), and annual visit frequency per patient were assessed. Piecewise Poisson regression models were constructed to examine visit volume trends. Predictors of patient's visit volume before and after the lockdown were examined using multivariable linear regression. RESULTS: Median patient age was 58 years; 84% were female; 82% used any disease-modifying anti-rheumatic drug (DMARD), and 62% used a targeted or biologic DMARD. Visit volume was stable 18 months prior to the COVID pandemic [slope 1.00 (95% confidence interval (CI) 0.99-1.01)] and increased at a rate of 2% per month post-lockdown [1.02 (95% CI 1.01-1.03)]. In-person visit volume was greatly reduced during the lockdown, with 61% virtual (51% video, 10% telephone). In the 18 months after lockdown, visit volume rebounded to pre-pandemic levels and continued to increase, with 11% virtual. Older age, serologic status, use of combination DMARDs, and non-steroidal anti-inflammatory drug (NSAID) use predicted greater visit volume during the pre-lockdown period. No variables predicted visit volume post-lockdown. CONCLUSION: While COVID caused a huge disruption in rheumatology practice, visit volume for RA rebounded in one American academic center, with an increasing slope in visit volume after lockdown.
引言:本研究旨在描述在新冠疫情封锁之前、期间和之后,某专科门诊的门诊量情况。 方法:我们评估了2018年11月至2021年9月期间,在新冠疫情封锁之前、期间和之后,某学术中心257例类风湿关节炎(RA)患者的每月面对面就诊量和虚拟就诊量(仅电话或视频)。主要结局是每月风湿科医生的就诊量。评估了就诊量、就诊类型(面对面就诊与虚拟就诊)以及每位患者的年度就诊频率。构建分段泊松回归模型以研究就诊量趋势。使用多变量线性回归分析封锁前后患者就诊量的预测因素。 结果:患者中位年龄为58岁;84%为女性;82%使用过任何改善病情抗风湿药物(DMARD),62%使用过靶向或生物DMARD。在新冠疫情大流行前18个月,就诊量稳定[斜率为1.00(95%置信区间(CI)0.99 - 1.01)]且在封锁后每月以2%的速度增加[1.02(95% CI 1.01 - 1.03)]。在封锁期间,面对面就诊量大幅减少, 61%为虚拟就诊(51%为视频就诊,10%为电话就诊)。在封锁后的前18个月,就诊量反弹至疫情前水平并持续增加,其中11%为虚拟就诊量。年龄较大、血清学状态、联合使用DMARDs以及使用非甾体抗炎药(NSAID)可预测封锁前的就诊量较高。没有变量可预测封锁后的就诊量。 结论:虽然新冠疫情给风湿病诊疗带来了巨大干扰,但在一个美国学术中心,类风湿关节炎的就诊量出现反弹,且封锁后的就诊量呈上升趋势。
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