Rheumatoid Arthritis Quality of Care in Alaska Natives

描述（由申请人提供）：类风湿性关节炎（RA）是美国人群发病和残疾的主要原因，在一些美洲印第安人和阿拉斯加土著部落中发病率较高。对于这种慢性疾病，早期发现和治疗可改善长期预后。现有的类风湿性关节炎治疗指南强调了早期积极治疗和频繁重新评估的重要性。类风湿关节炎的高质量护理可以显著影响病程。最近，关节炎基金会制定了一套27质量指标的护理类风湿性关节炎。该试点项目的目的是：1)对居住在安克雷奇服务单位的阿拉斯加原住民进行回顾性医疗记录审查，以确定遵守关节炎基金会27项风湿性关节炎质量指标中的8项的频率；2)收集可能影响护理质量的患者和提供者特征的信息；3)利用该试点研究的信息为阿拉斯加原住民类风湿关节炎护理质量的进一步研究提出假设，并制定质量改进计划。这些研究的长期目标是确定类风湿关节炎护理中存在哪些缺陷，确定导致这些缺陷的因素，并制定在全州范围内实施的质量改进计划，以改善阿拉斯加原住民类风湿关节炎的护理。相关性：类风湿性关节炎是一种慢性疾病，可导致关节畸形和功能丧失。如果关节炎得到适当治疗，风湿性关节炎长期后果的风险就会降低。这项研究与公共卫生相关，因为我们正在衡量为阿拉斯加本地人提供的类风湿关节炎的护理质量，最终目标是提高阿拉斯加本地人接受类风湿关节炎的护理质量。

DESCRIPTION (provided by applicant): Rheumatoid arthritis (RA) is a major cause of morbidity and disability in the U.S. population, with a higher prevalence in some American Indian and Alaska Native tribes. In this chronic illness, early identification and treatment of disease lead to improved long-term outcomes. Treatment guidelines exist for RA, stressing the importance of early, aggressive treatment with frequent reassessments. High-quality care for RA can substantially impact the disease course. Recently, the Arthritis Foundation developed a set of 27 quality indicators for the care of RA. The aims of this pilot project are to: 1) perform retrospective medical record review to determine the frequency of compliance with 8 of the Arthritis Foundation's 27 quality indicators for RA for Alaska Natives residing in the Anchorage Service Unit; 2) gather information on patient and provider characteristics that may influence quality of care; and 3) use the information from this pilot study to generate hypotheses for further studies of quality of care for RA in Alaska Natives and to develop quality improvement initiatives. The long-term goals of these studies are to determine what deficiencies are present in RA care, to determine factors contributing to these deficiencies, and to develop quality improvement initiatives to be implemented statewide to improve the care of Alaska Natives with RA. Relevance: Rheumatoid arthritis is a chronic condition that can lead to joint deformities and loss of function over time. If the arthritis is properly treated, the risk of long-term consequences from rheumatoid arthritis is reduced. This study is relevant to public health because we are measuring the quality of care provided for Alaska Natives with rheumatoid arthritis, with the ultimate goal of improving the quality of care that Alaska Natives receive for rheumatoid arthritis.