Improving access to care for rheumatology services in Canada.
Timothy S H KwokJessica WiddifieldPublished in: Clinical rheumatology (2023)
Rheumatic diseases are becoming increasingly prevalent in Canada, and its associated strain on the healthcare system is expected to increase over the next decades. Furthermore, there is an increasing body of evidence to suggest that access to rheumatology care is currently not meeting established quality of care benchmarks. To frame issues affecting access to care for rheumatology services in Canada, a proposed chronological framework from a rheumatology patient's perspective is proposed. Illustrating principles from a health policy lens including drawing from the stages heuristic framework and multiple streams theory, issues surrounding access to rheumatology assessment, to rheumatological investigations and lastly to appropriate treatment are explored. In particular, the current supply and demand mismatch within the rheumatology workforce presents challenges for patients in accessing rheumatic diseases providers. Potential policy solutions including increasing the pool of rheumatic diseases care providers, enhancing the clinical capacity with extended role providers and increasing uptake of virtual care are discussed. To ameliorate access to rheumatology investigations, the concept of provider education surrounding the appropriateness of investigations and merit-based funding are explored. Lastly, access to rheumatological treatment is framed using biologic therapies as an example, highlighting the policy challenges in biosimilar uptake and associated ethical and political considerations. By using a health policy lens to explore deficiencies within Canada's current system, the overarching goal of this analysis is to set the stage for reasoned and timely solutions in the future.
Keyphrases
- healthcare
- public health
- quality improvement
- palliative care
- mental health
- juvenile idiopathic arthritis
- affordable care act
- primary care
- pain management
- ejection fraction
- end stage renal disease
- systemic lupus erythematosus
- newly diagnosed
- risk assessment
- peritoneal dialysis
- combination therapy
- social media
- decision making
- smoking cessation
- cataract surgery
- replacement therapy
- chronic pain