Because Dr. Yelin is a co-editor of Arthritis Care & Research, review of this article was handled by the editor of Arthritis & Rheumatism.
Ambulatory visit utilization in a national, population-based sample of adults with osteoarthritis
Article first published online: 30 NOV 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 12, pages 1694–1703, 15 December 2009
How to Cite
Cisternas, M. G., Yelin, E., Katz, J. N., Solomon, D. H., Wright, E. A. and Losina, E. (2009), Ambulatory visit utilization in a national, population-based sample of adults with osteoarthritis. Arthritis & Rheumatism, 61: 1694–1703. doi: 10.1002/art.24897
- Issue published online: 30 NOV 2009
- Article first published online: 30 NOV 2009
- Manuscript Accepted: 23 JUL 2009
- Manuscript Received: 29 MAR 2009
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH. Grant Numbers: R01-AR053112, P60-AR47782, K24-AR02123, P60-AR053308
- Innovative Research grant from the Arthritis Foundation
To estimate the proportion of adults with osteoarthritis (OA) seeing various medical providers and ascertain factors affecting the likelihood of a patient seeing an OA specialist.
We used data from the Medical Expenditures Panel Survey, a stratified random sample of the noninstitutionalized civilian population. We classified adults as having symptomatic OA if their medical conditions included at least 1 occurrence of the International Classification of Diseases, Ninth Revision Clinical Modification, codes 715, 716, or 719, and if they reported joint pain, swelling, or stiffness during the previous 12 months. For the purpose of our analysis, we defined rheumatologists, orthopedists, and physical therapists as OA specialists. We first estimated the proportion of OA individuals seen by OA specialists and other health care providers in a 1-year period. We then used logistic regression to estimate the impact of demographic and clinical factors on the likelihood of an individual seeing an OA specialist.
A total of 9,933 persons met the definition of OA, representing 22.5 million adults in the US. Of these persons, 92% see physicians during the year, 34% see at least 1 OA specialist, 25% see an orthopedist, 11% see a physical therapist, and 6% see a rheumatologist. Higher educational attainment, having more comorbidities, and residing in the northeastern US are significant positive predictors for a patient seeing an OA specialist. Significant negative predictors for seeing an OA specialist are being unmarried but previously married and having no health insurance.
Most adults with OA do not visit OA specialists. Those without insurance and with lower levels of education are less likely to see these specialists.