Provision of Medical and Community Services to People With Severe Arthritis; An Audit

Abstract

We have identified severely disabled arthritics who live in the community through social service records. All had either rheumatoid arthritis (RA) or osteoarthritis (OA). The diagnosis influenced referral to hospital, those with RA being referred while only half of those with OA had been referred. Referral was important for both surgical and environmental intervention. Provision of social services and community occupational therapy services was greater if the patients had been seen in hospital departments irrespective of the diagnosis. Recipients of joint surgery had all gained temporary benefit although progression of arthritis or other disabling disease compromised this after several years. There was a substantial minority of people with severe OA living in the community who had not been considered for joint replacement and did not have optimal provision of aids, appliances and environmental adaptation.

Factors influencing the use of community health and social services by those aged 65 and over

“…1983, Blaxter 1987. As would be expected, the use of community health and social services is associated with increasing age, living alone, limited functional status, being less well off financially, being in receipt of supplementary benefit and being referred to hospital (Arber et al 1988, Bowling et al 1991, Victor & Vetter 1986, Vetter et al 1987& Foster et al 1991. General practitioner (GP) consultation rates rise with age and relate particularly to diseases of the circulatory, respiratory and muscular skeletal systems (RCGP 1986), with a concomitant rise in drug prescribing (Cartwright & Smith 1988).…”