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Predictors of Transition to Adult Rheumatology Care Explored

Insurance coverage, referral from pediatric rheumatologist predict shorter time to adult visit

FRIDAY, Sept. 11, 2020 (HealthDay News) — For pediatric patients transferring to an adult rheumatology clinic, continued insurance coverage and referral from a pediatric rheumatologist predict shorter time to completed adult visit, according to a study published online Sept. 9 in Arthritis Care & Research.

Nicole Bitencourt, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a retrospective analysis of pediatric patients transferring to an adult rheumatology clinic to quantify the time between final pediatric and first adult visits and to assess health care utilization. Data were included for 141 pediatric patients who transferred care.

The researchers found that there was a mean of 221 days between final pediatric and first completed adult rheumatology visit. Continued insurance coverage, younger age at referral, and referral from a pediatric rheumatologist were predictive of shorter time to completed adult visit in regression modeling. Connective tissue disease (CTD) diagnosis and Black race were factors associated with hospitalizations (odds ratios, 8.54 and 3.04, respectively) and emergency department visits (odds ratios, 3.6 and 6.0, respectively). Fifteen percent of patients with CTD had end-stage renal disease or death.

“It may be helpful for pediatric rheumatologists to have a system in place to ensure patients are not lost to follow up before establishing care with an adult rheumatologist,” Bitencourt said in a statement.

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