Access to pediatric rheumatology subspecialty care in British Columbia, Canada

Natalie J. Shiff, Reem Abdwani, David A. Cabral, Kristin M. Houghton, Peter N. Malleson, Ross E. Petty, Victor M. Espinosa, Lori B. Tucker

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Objective. Early recognition and treatment of pediatric rheumatic diseases is associated with improved outcome. We documented access to pediatric rheumatology subspecialty care for children in British Columbia (BC), Canada, referred to the pediatric rheumatology clinic at BC Children's Hospital, Vancouver. Methods. An audit of new patients attending the outpatient clinic from May 2006 to February 2007 was conducted. Parents completed a questionnaire through a guided interview at the initial clinic assessment. Referral dates were obtained from the referral letters. Patients were classified as having rheumatic disease, nonrheumatic disease, or a pain syndrome based on final diagnosis by a pediatric rheumatologist. Results. Data were collected from 124 of 203 eligible new patients. Before pediatric rheumatology assessment, a median of 3 healthcare providers were seen (range 1-11) for a median of 5 visits (range 1-39). Overall, the median time interval from symptom onset to pediatric rheumatology assessment was 268 days (range 13-4989), and the median time interval from symptom onset to referral to pediatric rheumatology was 179 days (range 3-4970). Among patients ultimately diagnosed with rheumatic diseases (n = 53), there was a median of 119 days (range 3-4970) from symptom onset to referral, and 169 days (range 31-4989) from onset to pediatric rheumatology assessment. Conclusion. Children and adolescents with rheumatic complaints see multiple care providers for multiple visits before referral to pediatric rheumatology, and there is often a long interval between symptom onset and this referral. The Journal of Rheumatology

Original languageEnglish
Pages (from-to)410-415
Number of pages6
JournalJournal of Rheumatology
Issue number2
Publication statusPublished - Feb 2009


  • Health services needs and demand
  • Juvenile idiopathic arthritis
  • Pediatric rheumatic diseases

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology


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