Quality of Care for Patients With Rheumatoid Arthritis

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Abstract
Rheumatoid arthritis is a chronic disabling condition that affects 1% of US adults.1 It causes substantial morbidity2-4 and is associated with a 5- to 15-year reduction in life expectancy.5-11 Early death stems not from the arthritis per se, but rather from comorbid diseases that commonly affect the general population.12 Several factors may contribute to these premature deaths. First, pathophysiologic features of rheumatoid arthritis may accelerate the courses of other diseases.13-15 Next, medications used to treat rheumatoid arthritis may cause or exacerbate other diseases.16,17 Finally, patients with rheumatoid arthritis may not receive adequate treatment for comorbid diseases, perhaps because the attention of patients and/or physicians is focused on the arthritis. The few studies that have assessed comorbid disease care among patients with specific underlying chronic diseases suggest that the quality of health care for patients with comorbid diseases may be poor.18-21 However, no studies have examined how physician specialty affects quality of care across a spectrum of diseases in patients with a single chronic condition, such as rheumatoid arthritis.