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Rheumatic diseases varied among patients seen in Puerto Rican university, community settings
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Several demographic and clinical differences were observed in patients seen at university-based compared with community-based rheumatology practices in Puerto Rico, according to study results.
Researchers reviewed 11,373 claim forms submitted to insurance companies in 2007 from the University of Puerto Rico Medical Sciences Campus (UPR-MSC) Adult Rheumatology Training Program practice (n=1,952) and three community-based rheumatology practices (n=9,421). They examined demographic parameters, primary diagnoses, medical visits and rheumatologic procedures.
The UPR-MSC setting had younger patients (mean age, 44.4 years vs. 55.4 years) and a slightly higher percentage of women (87.8% vs. 85.9%) compared with community practices. It also reported more autoimmune diseases (65.3% vs. 37.6%), systemic lupus erythematosus (40% vs. 12.3%), rheumatoid arthritis (16.9% vs. 10.6%) and gouty arthritis (1.4% vs. 0.5%) (P<.001 for all).
The community practices reported more osteoarthritis (24.4% vs. 9.8%), fibromyalgia (7.4% vs. 1.9%) and regional rheumatic pain syndromes (7.2% vs. 1.4%). The university practice claim forms reported more ED visits (11.8% vs. 0.3%), while patients at community practices experienced more joint and periarticular injections (13.3% vs. 2.9% and 6.2% vs. 1.7%, respectively) (P<.001 for all).
“Based on the results of this study … we created a new rotation in which [UPR-MSC rheumatology] fellows attend three community rheumatology practices,” the researchers reported. “This experience has rounded their exposure to a wide diversity of patient populations and rheumatologic conditions and has improved their skills in performing rheumatic procedures.
“This study has important implications to subspecialty training in rheumatology as it demonstrates several demographic and clinical differences among patients seen at university- and community-based rheumatology practices in Puerto Rico.”
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