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Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres
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  • Published on:
    IMPLEMENTATION OF AN EARLY PATIENT REFERRAL PROGRAM FOR HAND ARTHRALGIA. MEXICAN EXPERIENCE
    • David Vega-Morales, Rheumatologist Instituto Mexicano del Seguro Social. IMSS Hospital General de Zona Número 17.
    • Other Contributors:
      • Alain N M Granados-Silva, resident doctor
      • Alondra E Montoya-Montes, medical intern of social service

    Dear Editor,

    I am writing to express our particular interest in the article "Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres" by Dreher et al (1), where a prospective multicenter study was conducted with the implementation of an early referral strategy that succeeded in reducing the rheumatological medical care waiting time to 6.6 months, compared to the usual reference time of 27.7 months.

    It is undeniable that the delay in referring patients with suspected rheumatoid arthritis remains a challenge. In a report conducted at a second-level hospital in Mexico, we evaluated 206 referrals to the rheumatology service from the primary level of care. We found an average of 28.2 (SD 46.9) months elapsed from the onset of symptoms to rheumatological evaluation (2).

    In contrast, the study by van Nies et al conducted in the Netherlands established an early referral clinic, which managed to reduce the referral time from the general practitioner to 2 weeks and the total time elapsed from the onset of symptoms to rheumatological care to 10.6 weeks. 59% (n=162) received attention within the first 12 weeks after the onset of symptoms (3).

    Within the referral system at the Mexican Social Security Institute in Monterrey, Mexico, we implemented an early referral program with the aim of reducing referral times. The program was applied to patients evaluated at the primary level who presented hand arth...

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    Conflict of Interest:
    None declared.