PROVISION OF MEDICAL AND COMMUNITY SERVICES TO PEOPLE WITH SEVERE ARTHRITIS; AN AUDIT

We have identified severely disabled arthritics who live inthe community through social service records. All had eitherrheumatoid arthritis (RA) or osteoarthritis (OA). The diagnosisinfluenced referral to hospital, those with RA being referredwhile only half of those with OA had been referred. Referralwas important for both surgical and environmental intervention.Provision of social services and community occupational therapyservices was greater if the patients had been seen in hospitaldepartments irrespective of the diagnosis. Recipients of jointsurgery had all gained temporary benefit although progessionof arthritis or other disabling disease compromised this afterseveral years. There was a sub stantial minority of people withsevere OA living in the community who had not been consideredfor joint replacement and did not have optimal provision ofaids, appliances and environmental adaptation. KEY WORDS: RA, OA, Disability, HAQ, Joint surgery, Occupational therapy, Community support, Outcome