Abstract
BackgroundThis study looks at access to care for Juvenile Idiopathic Arthritis through pediatric rheumatology in the UAE, as an example of multi-ethnic society.MethodsPatients with a diagnosis of Juvenile idiopathic arthritis were identified through the hospital electronic medical records system from January 1st 2011 to December 31st 2014. All residents of the United Arab Emirates hold an Emirates identity card. We divided our patients into two groups: Emirati-Emirates, who are native Emirati children and hold the Emirati nationality, as stated on their Emirates identity card, and who therefore have full, comprehensive access to free medical care; and non-Emirati-Emirates, who represent other nationalities, as stated on their Emirates identity card. The primary objective of this study is to look at access to care for Juvenile idiopathic arthritis through pediatric rheumatology in the two groups. The secondary objective is to look at the effect of having multiple types of healthcare insurance coverage on access to biologics. A retrospective review was carried out.ResultsSixty-six patients with JIA identified: 33 Emirates and 33 non-Emirates. For Emirates, the mean time from onset to first appointment with pediatric rheumatologist and diagnosis is 9 months (range: 1–48), and for non-Emirates is 12.4 months (range: 1–96). Among the Emirates, 10 patients are currently on biologic with methotrexate. Among the non-Emirates, 15 are on biologic with methotrexate. Among the Emirates, 12 are currently in remission while on treatment, as are 10 non-Emirates. Regarding disability, one Emirati patient has blindness secondary to noncompliance while under previous treatment. One Non-Emirati developed joint deformities due to periods of noncompliance and no follow up.ConclusionsDelay in presentation to pediatric rheumatology has been identified as an important factor in our population, which is multi-cultural and multi-ethnic. Type of health care insurance cover did not affect number of patients getting biological therapy once patient seen in the pediatric rheumatology service.
Highlights
This study looks at access to care for Juvenile Idiopathic Arthritis through pediatric rheumatology in the United Arab Emirates (UAE), as an example of multi-ethnic society
The primary objective of this study is to look at access to care for Juvenile Idiopathic Arthritis (JIA) through pediatric rheumatology in the UAE, which is taken as an example of multi-ethnic society
For the primary objective to look at access to care for JIA through pediatric rheumatology in the UAE we examined the following: percentage of EE children relative to total number of children; subtypes of JIA, according to International League of Associations for Rheumatology (ILAR) classification in each group [2]; time in months from onset to first appointment in pediatric rheumatology and diagnosis, number of health professionals seen prior to referral to pediatric rheumatology, number of self referrals; number of patients on steroids prior to first appointment with rheumatology, number of patients referred to ophthalmology and number of patients with uveitis
Summary
This study looks at access to care for Juvenile Idiopathic Arthritis through pediatric rheumatology in the UAE, as an example of multi-ethnic society. Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disease that affects 1 in 1000 children worldwide [1]. It is a heterogeneous group of autoimmune conditions classified into seven different subtypes, based on the clinical features in the first 6 months of presentation, according to International League of Associations of Rheumatology’ classification system [2]. An out reach clinic provided once weekly to Khawaja and Al-Maini Pediatric Rheumatology (2017) 15:41 the other main public hospital in Abu Dhabi. Patients included from both hospitals as the can be seen in either hospital
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