Crynodeb
Objectives We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland and Wales, we identified people with a diagnosis of RA before 1 April 2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month [April 2019 to December 2022 (Wales and Scotland), November 2023 (England)] and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results We identified 145 065, 3813 and 13 637 people coded with RA in England, Scotland and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male and living in rural areas. Ethnic minorities, those living in more deprived and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England.
| Iaith wreiddiol | Saesneg |
|---|---|
| Rhif yr erthygl | keaf559 |
| Cyfnodolyn | Rheumatology |
| Cyfrol | 65 |
| Rhif cyhoeddi | 1 |
| Dynodwyr Gwrthrych Digidol (DOIs) | |
| Statws | Cyhoeddwyd - 24 Hyd 2025 |
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Yn: Rheumatology, Cyfrol 65, Rhif 1, keaf559, 24.10.2025.
Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
TY - JOUR
T1 - Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond
T2 - a cohort study in three nations of the UK
AU - Costello, Ruth E.
AU - Parker, Michael
AU - Kennedy, Jonathan
AU - Brophy, Sinead
AU - Mehrkar, Amir
AU - Bacon, Sebastian
AU - Goldacre, Ben
AU - Mackenna, Brian
AU - Evans, Dave
AU - Tomlinson, Laurie A.
AU - Hollick, Rosemary J.
AU - Humphreys, Jenny H.
AU - Walker, Alex J.
AU - Inglesby, Peter
AU - Curtis, Helen J.
AU - Morton, Caroline E.
AU - Morley, Jessica
AU - Bacon, Sebastian C.J.
AU - Hickman, George
AU - Croker, Richard
AU - Evans, David
AU - Ward, Tom
AU - Devito, Nicholas J.
AU - Fisher, Louis
AU - Green, Amelia C.A.
AU - Massey, Jon
AU - Smith, Rebecca M.
AU - Hulme, William J.
AU - Davy, Simon
AU - Andrews, Colm D.
AU - Hopcroft, Lisa E.M.
AU - Drysdale, Henry
AU - Dillingham, Iain
AU - Park, Robin Y.
AU - Higgins, Rose
AU - Cunningham, Christine
AU - Wiedemann, Milan
AU - Nab, Linda
AU - Maude, Steven
AU - Macdonald, Orla
AU - Butler-Cole, Ben F.C.
AU - O'dwyer, Thomas
AU - Stables, Catherine L.
AU - Wood, Christopher
AU - Brown, Andrew D.
AU - Speed, Victoria
AU - Bridges, Lucy
AU - Schaffer, Andrea L.
AU - Walters, Caroline E.
AU - Rentsch, Christopher T.
AU - Bhaskaran, Krishnan
AU - Schultze, Anna
AU - Williamson, Elizabeth J.
AU - Mcdonald, Helen I.
AU - Mathur, Rohini
AU - Eggo, Rosalind M.
AU - Wing, Kevin
AU - Wong, Angel Y.S.
AU - Tazare, John
AU - Grieve, Richard
AU - Grint, Daniel J.
AU - Langan, Sinead
AU - Mansfield, Kathryn E.
AU - Douglas, Ian J.
AU - Evans, Stephen J.W.
AU - Smeeth, Liam
AU - Walker, Jemma L.
AU - Forbes, Harriet
AU - Cowling, Thomas E.
AU - Herrett, Emily L.
AU - Zheng, Bang
AU - Parker, Edward P.K.
AU - Bates, Christopher
AU - Cockburn, Jonathan
AU - Parry, John
AU - Hester, Frank
AU - Harper, Sam
AU - O'hanlon, Shaun
AU - Eavis, Alex
AU - Jarvis, Richard
AU - Avramov, Dima
AU - Griffiths, Paul
AU - Fowles, Aaron
AU - Parkes, Nasreen
AU - Nicholson, Brian
AU - Perera, Rafael
AU - Harrison, David
AU - Khunti, Kamlesh
AU - Sterne, Jonathan A.C.
AU - Quint, Jennifer
AU - Chaturvedi, Nishi
AU - Park, Chloe
AU - Carnemolla, Alisia
AU - Williams, Dylan
AU - Knueppel, Anika
AU - Boyd, Andy
AU - Turner, Emma L.
AU - Evans, Katharine M.
AU - Thomas, Richard
AU - Berman, Samantha
AU - Mclachlan, Stela
AU - Crane, Matthew
AU - Whitehorn, Rebecca
AU - Oakley, Jacqui
AU - Foster, Diane
AU - Woodward, Hannah
AU - Campbell, Kirsteen C.
AU - Timpson, Nicholas
AU - Kwong, Alex
AU - Soares, Ana Goncalves
AU - Griffith, Gareth
AU - Toms, Renin
AU - Jones, Louise
AU - Annie, Herbert
AU - Mitchell, Ruth
AU - Palmer, Tom
AU - Sterne, Jonathan
AU - Walker, Venexia
AU - Huntley, Lizzie
AU - Fox, Laura
AU - Denholm, Rachel
AU - Knight, Rochelle
AU - Northstone, Kate
AU - Kanagaratnam, Arun
AU - Horne, Elsie
AU - North, Teri
AU - Taylor, Kurt
AU - Arab, Marwa A.L.
AU - Walker, Scott
AU - Coronado, Jose I.C.
AU - Karthikeyan, Arun S.
AU - Ploubidis, George
AU - Moltrecht, Bettina
AU - Booth, Charlotte
AU - Parsons, Sam
AU - Wielgoszewska, Bozena
AU - Bridger-Staatz, Charis
AU - Steves, Claire
AU - Thompson, Ellen
AU - Garcia, Paz
AU - Cheetham, Nathan
AU - Bowyer, Ruth
AU - Freydin, Maxim
AU - Roberts, Amy
AU - Walker, Alex
AU - Morley, Jess
AU - Hulme, William
AU - Andrews, Colm
AU - Curtis, Helen
AU - Hopcroft, Lisa
AU - Green, Amelia
AU - Patalay, Praveetha
AU - Maddock, Jane
AU - Patel, Kishan
AU - Stafford, Jean
AU - Jacques, Wels
AU - Tilling, Kate
AU - Macleod, John
AU - Mcelroy, Eoin
AU - Shah, Anoop
AU - Silverwood, Richard
AU - Denaxas, Spiros
AU - Flaig, Robin
AU - Mccartney, Daniel
AU - Campbell, Archie
AU - Tomlinson, Laurie
AU - Herrett, Emily
AU - Cowling, Thomas
AU - Mansfield, Kate
AU - Wang, Kevin
AU - Mansfield, Kathryn
AU - Douglas, Ian
AU - Mceachan, Rosie
AU - Wright, John
AU - Willan, Kathryn
AU - Badrick, Ellena
AU - Santorelli, Gillian
AU - Yang, Tiffany
AU - Hou, Bo
AU - Steptoe, Andrew
AU - Giorgio, Di Gessa
AU - Zhu, Jingmin
AU - Zaninotto, Paola
AU - Wood, Angela
AU - Cezard, Genevieve
AU - Ip, Samantha
AU - Bolton, Tom
AU - Sampri, Alexia
AU - Rafeti, Elena
AU - Almaghrabi, Fatima
AU - Sheikh, Aziz
AU - Shah, Syed A.
AU - Katikireddi, Vittal
AU - Shaw, Richard
AU - Hamilton, Olivia
AU - Green, Michael
AU - Kromydas, Theocharis
AU - Kopasker, Daniel
AU - Greaves, Felix
AU - Willans, Robert
AU - Glen, Fiona
AU - Sharp, Steve
AU - Hughes, Alun
AU - Wong, Andrew
AU - Howes, Lee Hamill
AU - Rapala, Alicja
AU - Nigrelli, Lidia
AU - Mcardle, Fintan
AU - Beckford, Chelsea
AU - Raman, Betty
AU - Dobson, Richard
AU - Folarin, Amos
AU - Stewart, Callum
AU - Ranjan, Yatharth
AU - Carpentieri, Jd
AU - Sheard, Laura
AU - Fang, Chao
AU - Baz, Sarah
AU - Gibson, Andy
AU - Kellas, John
AU - Neubauer, Stefan
AU - Piechnik, Stefan
AU - Lukaschuk, Elena
AU - Saunders, Laura C.
AU - Wild, James M.
AU - Smith, Stephen
AU - Jezzard, Peter
AU - Tunnicliffe, Elizabeth
AU - Sanders, Zeena Britt
AU - Finnigan, Lucy
AU - Ferreira, Vanessa
AU - Green, Mark
AU - Rhead, Rebecca
AU - Kibble, Milla
AU - Wei, Yinghui
AU - Lemanska, Agnieszka
AU - Perez-Reche, Francisco
AU - Piehlmaier, Dominik
AU - Teece, Lucy
AU - Parker, Edward
AU - Black, Corri
AU - Choy, Ernest
AU - Macfarlane, Gary
AU - Bennett, Louise
AU - Philip, Lorna
AU - Stevenson, Michelle
AU - Mcfarlane, Denise
AU - Moir, Laura
AU - Allotay, Ian
AU - Bell, Philip
AU - Cheesley, Amanda
AU - Marlow, Charlotte
AU - Kausir, Farzana
AU - Lam, Emily
AU - Wood, Inga
N1 - Publisher Copyright: © 2025 The Author(s).
PY - 2025/10/24
Y1 - 2025/10/24
N2 - Objectives We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland and Wales, we identified people with a diagnosis of RA before 1 April 2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month [April 2019 to December 2022 (Wales and Scotland), November 2023 (England)] and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results We identified 145 065, 3813 and 13 637 people coded with RA in England, Scotland and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male and living in rural areas. Ethnic minorities, those living in more deprived and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England.
AB - Objectives We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland and Wales, we identified people with a diagnosis of RA before 1 April 2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month [April 2019 to December 2022 (Wales and Scotland), November 2023 (England)] and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results We identified 145 065, 3813 and 13 637 people coded with RA in England, Scotland and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male and living in rural areas. Ethnic minorities, those living in more deprived and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England.
KW - delivery of health care
KW - inequalities
KW - observational studies
KW - organization of health care
KW - rheumatoid arthritis
UR - https://www.scopus.com/pages/publications/105029233054
U2 - 10.1093/rheumatology/keaf559
DO - 10.1093/rheumatology/keaf559
M3 - Article
C2 - 41134187
AN - SCOPUS:105029233054
SN - 1462-0324
VL - 65
JO - Rheumatology
JF - Rheumatology
IS - 1
M1 - keaf559
ER -