Healthcare resource utilisation
| Characteristics | Incoming P3 patients (n=79) | Priority-level pathway | |||
| P3→P4→P3 (n=21) | P3→P3→P3 (n=43) | P3→P4→P2 (n=4) | P3→P2→P2 (n=11) | ||
| Investigations ordered (n, %) | 29 (37%) | 21 (100%) | 2 (5%) | 4 (100%) | 2 (18%) |
| Imaging (n, %) | 28 (35%) | 20 (95%) | 2 (5%) | 4 (100%) | 2 (18%) |
| MRI | 5 (6%) | 5 (24%) | 0 | 0 | 0 |
| X-ray | 26 (33%) | 19 (90%) | 1 (2%) | 4 (100%) | 2 (18%) |
| Ultrasound | 3 (4%) | 1 (5%) | 1 (2%) | 1 (25%) | 0 |
| Labs (n, %)* | 14 (18%) | 12 (57%) | 0 | 2 (50%) | 0 |
| Rheumatological workup | 14 (18%) | 12 (57%) | 0 | 2 (50%) | 0 |
| Non-rheumatological workup | 5 (6%) | 3 (14%) | 0 | 2 (50%) | 0 |
| Routine workup | 8 (10%) | 6 (29%) | 0 | 2 (50%) | 0 |
| Other investigations (EMG/NCS, ECG) | 1 (1%) | 1 (5%) | 0 | 0 | 0 |
| Medications prescribed (n, %) | 8 (10%) | 4 (19%) | 2 (5%) | 2 (50%) | 0 |
| NSAID | 4 (5%) | 3 (14%) | 1 (2%) | 0 | 0 |
| Neuropathic | 2 (3%) | 1 (5%) | 1 (2%) | 0 | 0 |
| Steroid | 1 (1%) | 0 | 0 | 1 (25%) | 0 |
| Muscle relaxant | 1 (1%) | 0 | 0 | 1 (25%) | 0 |
| Referral to medical specialty (n, %) | 1 (1) | 0 | 0 | 0 | 1 (9) |
| Neurology | 0 | 0 | 0 | 0 | 0 |
| Dermatology | 1 (1%) | 0 | 0 | 0 | 1 (9%) |
| Referral to allied health profession (n, %) | 43 (54%) | 8 (38%) | 26 (60%) | 4 (100%) | 5 (45%) |
| Athletic therapy, physiotherapy, occupational therapy, chiropractor clinic, foot care clinic | 37 (47%) | 6 (29%) | 22 (51%) | 4 (100%) | 5 (45%) |
| TAPMI pain clinic | 5 (6%) | 2 (10%) | 3 (7%) | 0 | 0 |
| Mental health in medicine | 3 (4%) | 1 (5%) | 2 (5%) | 0 | 0 |
| Follow-up | |||||
| Follow-up scheduled after initial consult | 14 (18%) | 8 (38%) | 2 (5%) | 2 (50%) | 2 (18%) |
| Median number of follow-ups per patient | 0 | 0 | 0 | 0 | 0 |
| 0 | 60 (76%) | 9 (43%) | 40 (93%) | 2 (50%) | 9 (82%) |
| 1 | 14 (18%) | 9 (43%) | 3 (7%) | 1 (25%) | 1 (9%) |
| 2 | 3 (4%) | 2 (10%) | 0 | 1 (25%) | 0 |
| 3 | 1 (1%) | 0 | 0 | 0 | 1 (9%) |
*Labs:
· Rheumatological workup: HLA-B27, CRP, ESR, RF, anti-CCP (funded through hospital laboratory services), anti-dsDNA, C3, C4, ENA, CK, microalbumin/creatinine urine ratio, urinalysis, blood fluid cell count, cytology, fluid differential and uric acid.
· Non-rheumatological workup: PTH, serum protein electrophoresis, lactate dehydrogenase, folate, calcium profile, magnesium, IgG/IgA/IgM, coeliac profile and blood film.
· Routine workup: albumin, ALT, CBC, AST, liver profile (bilirubin, ALT, ALP), serum creatinine, vitamin D 25-OH, vitamin B12, TSH, free T4, HbA1c and ferritin.
· Other investigations: EMG/nerve conduction studies and echocardiogram.
ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CBC, complete blood count; CCP, cyclic citrullinated peptide; CK, creatine kinase; CRP, C-reactive protein; EMG, electromyography; ENA, extractable nuclear antigen; ESR, erythrocyte sedimentation rate; NCS, nerve conduction studies; NSAID, non-steroidal anti-inflammatory drug; PTH, parathyroid hormone; RF, rheumatoid factor; TAPMI, Toronto Academic Pain Medicine Institute; TSH, thyroid-stimulating hormone.