Evidence map›Paper›PMID 35277162›Full record

ArticleBMC health services research2022

The impact of introducing multidisciplinary care assessments on access to rheumatology care in British Columbia: an interrupted time series analysis.

Ross Duncan, Lucy Cheng, Michael R Law, Kam Shojania, Mary A De Vera, Mark Harrison

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ross DuncanFaculty of Pharmaceutical Sciences, University of British Columbia, 2405-4625 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Lucy ChengSchool of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada.
Michael R LawSchool of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada.
Kam ShojaniaArthritis Research Canada, Richmond, BC, Canada.
Mary A De VeraFaculty of Pharmaceutical Sciences, University of British Columbia, 2405-4625 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Mark HarrisonFaculty of Pharmaceutical Sciences, University of British Columbia, 2405-4625 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. mark.harrison@ubc.ca.

Funding

Arthritis Society SOG-16-369CIHR 201603Michael Smith Foundation for Health Research Scholar Award
6 · The paper itself

Abstract

backgroundIn 2011 the British Columbia (BC) Ministry of Health introduced a new fee-for-service billing code that allowed "Multidisciplinary Care Assessment" (MCA). This change has the potential to change access to and quality of care for patients. This study aimed to explore the impact on access to rheumatology services in the province.

methodsFee-for-service rheumatology billings were evaluated for each rheumatologist 2 years before and after use of the MCA code. Numbers of 1) unique patients and 2) services provided per month were used as proxy measures of access to care. A multiple-baseline interrupted time series model assessed the impact of the MCA on levels and trends of the access outcomes.

resultsOur analysis consisted of 82,360 patients cared for by 26 rheumatologists who billed for an MCA. In our primary analysis we observed a sustained increase in the mean number of unique patients of 4.9% (95% CI: 0.0% to 9.9%, p = 0.049) and the mean number of services of 7.1% (95% CI: 1.0% to 13.6%, (p = 0.021), per month provided by a rheumatologist, corresponding to the initial use of MCA.

conclusionThe introduction of the MCA code was associated with an initial increase in the measures of access, which was maintained but did not increase over time. Our study suggests that the use of Multidisciplinary Care Assessment can contribute to expanding and/or sustaining access to care for people with complex chronic conditions, like rheumatic diseases.

Indexed as

Rheumatic DiseasesRheumatologyBritish ColumbiaHealth Services AccessibilityHumansInterrupted Time Series AnalysisCanadaFee for serviceInterrupted time seriesPolicyRheumatology

Identifiers

PMID35277162
PMCPMC8915460

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.