Abstract
BackgroundTimely access to effective treatments for arthritis is a priority at national, provincial and regional levels in Canada due to population aging coupled with limited health human resources. Models of care for arthritis are being implemented across the country but mainly in local contexts, not from an evidence-informed policy or framework. The purpose of this study is to examine existing models of care for arthritis in Canada at the local level in order to identify commonalities and differences in their implementation that could point to important considerations for health policy and service delivery.MethodsSemi-structured key informant interviews were conducted with 70 program managers and/or care providers in three Canadian provinces identified through purposive and snowball sampling followed by more detailed examination of 6 models of care (two per province). Interviews were transcribed verbatim and analyzed thematically using a qualitative descriptive approach.ResultsTwo broad models of care were identified for Total Joint Replacement and Inflammatory Arthritis. Commonalities included lack of complete and appropriate referrals from primary care physicians and lack of health human resources to meet local demands. Strategies included standardized referrals and centralized intake and triage using non-specialist health care professionals. Differences included the nature of the care and follow-up, the role of the specialist, and location of service delivery.ConclusionsCurrent models of care are mainly focused on Total Joint Replacement and Inflammatory Arthritis. Given the increasing prevalence of arthritis and that published data report only a small proportion of current service delivery is specialist care; provision of timely, appropriate care requires development, implementation and evaluation of models of care across the continuum of care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1634-9) contains supplementary material, which is available to authorized users.
Highlights
Access to effective treatments for arthritis is a priority at national, provincial and regional levels in Canada due to population aging coupled with limited health human resources
Given the prevalence of arthritis (1 in 6 Canadians have some form of arthritis) and that the prevalence is expected to increase by more than 50 % by 2020 [2] due to population aging and increasing rates of obesity coupled with limited health human resources to treat people with arthritis and musculoskeletal conditions, access to care issues are likely to continue to dominate the health care agenda
The key informants had between 1 and 36 years of experience related to arthritis management and care
Summary
Access to effective treatments for arthritis is a priority at national, provincial and regional levels in Canada due to population aging coupled with limited health human resources. Professional organizations (e.g. Canadian Orthopaedic Association, Canadian Rheumatology Association, Arthritis Health Professionals Association, Arthritis Alliance of Canada etc.) have identified models of care for arthritis as a priority and funding agencies such as the Canadian Institutes of Health Research Institute of Health Services [3] and Policy Research and The Arthritis Society [4] have stated research priorities in the development and evaluation of innovative models of care for arthritis Given these agendas, we need an understanding of the landscape of existing models of care for arthritis such that future work can address gaps and opportunities and models of care can be developed, implemented and evaluated to maximize care and outcomes for people with arthritis
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