La atención médica en reumatología en un hospital de segundo nivel de atención

Introduction: Studies evaluating the pattern of diseases evaluated by rheumatology services are required to improve the planning of healthcare resource distribution. Aim: To describe the pattern of diseases motivating consultations in an outpatient clinic of a secondary care center in Guadalajara, Mexico. Material and methods: A cross-sectional, descriptive study was performed. Data on the diseases evaluated in the rheumatology service and other healthcare indicators were obtained through a search of the hospital's computerized database. The number of initial and repeat consultations, their distribution by age and sex, the mean monthly number of prescriptions, and other indicators of performance were identified. Results: There were 5,790 consultations in 1 year (26% were initial visits). The three most frequent diseases were: rheumatoid arthritis (47.1%, 95% CI 46-48%), systemic lupus erythematosus (12.7%, 95% CI 12-14%), and ankylosing spondylitis (7.7%, 95% CI 7-8%). Four women were attended for each man. Consultations were most frequent in the group aged 30-59 years old. The mean number of consultations per rheumatologist/month was 242, with a mean of 2.5 prescriptions per patient. The rate of compliance with appointments was 85%. A mean of 7.5 were diagnosed with temporary work disability for each rheumatologist/month. Conclusions: The most prevalent disorders in our outpatient rheumatology clinic were inflammatory joint diseases and systemic autoimmune diseases. These disorders required a high proportion of health-care resource. Further studies are required to evaluate the costs of these resources with the aim of establising better strategies for the health care needs in these patients.