Does billing for rheumatology consultations benefit patients and the health care system?
Rheumatic diseases are the most common source of severe pain and disability in Canada, and have wide-ranging impacts on peoples' lives including their health-related quality of life, ability to work, financial situation, and use of the health care system.
In 2012, BC's Ministry of Health introduced a code allowing rheumatologists to bill for rheumatology nurse consultations for complex rheumatic diseases. This code has been used over 30,000 times at a cost of $6.5million, however, it is unclear whether the BC model results in real-world benefits that mirror those from clinical trials.
Data access has been approved for a population-based analysis of multi-disciplinary rheumatology nursing care for people with complex rheumatic diseases. The study, funded by the Canadian Institutes of Health Research and The Arthritis Society, is being led by Dr. Mark Harrison, Assistant Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia.
“Our research will study an example of the type of intervention recommended by the Health Care Innovation Group of Canada’s Premiers and the BC Ministry of Health,” says Dr. Harrison. “The evaluation of this policy will have obvious implications for BC, but will also provide valuable information for other health jurisdictions within Canada and internationally who may be looking to implement similar programs in rheumatic diseases and other chronic diseases. The research will be able to inform policy either in justifying the existence of this incentive and its implementation elsewhere, or in justifying modifications if the incentive is found to be ineffective according to our hypotheses and analyses.”
For the project PopData will link internally-managed data from the BC Ministry of Health, BC Vital Statistics Agency, WorkSafe BC, Statistics Canada and Immigration, Refugees and Citizenship Canada, with researcher-collected data and data from Vancouver Coastal Health, Lifelabs and the National Ambulatory Care Reporting Database (NACRS).