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Background: REGIONAL DISPARITIES, COSTS, COORDINATION, RHEUMATOLOGIC CARE.
To analyze the current disparities in access to care for patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) across different regions in Italy.
To evaluate the impact of these disparities on the quality of life, functional limitations, and overall health outcomes of patients.
To identify the structural, organizational, and geographical barriers that contribute to inequalities in the healthcare system for rheumatologic diseases.
To propose strategic solutions for standardizing Diagnostic-Therapeutic Care Pathways (PDTA) to ensure equitable access to care across the national territory.
To promote the implementation of multidisciplinary care models that foster collaboration among rheumatologists, pharmacists, general practitioners, and other specialists.
To highlight the potential of digital technologies and telemedicine in overcoming geographical barriers and improving access to innovative therapies and healthcare services.
To advocate for coordinated efforts among healthcare institutions, patient associations, and policymakers to reduce inequalities and optimize the use of resources.
Study Design: Cross-sectional, observational analysis of access to care for RA and PsA patients across Italy.
Data Collection: Data from national health databases, patient registries, and surveys on healthcare infrastructure, treatment availability, and patient outcomes.
Sample Population: Representative sample of patients with RA and PsA from different Italian regions, based on medical records and diagnostic codes.
Variables:
Access to Care: Waiting times, treatment availability, proximity to specialized facilities.
Quality of Life: Health Assessment Questionnaire (HAQ) and Short Form Health Survey (SF-36).
Healthcare Costs: Direct (medical treatments, hospitalizations) and indirect (loss of productivity, caregiving burden).
Regional Disparities: Differences in healthcare infrastructure, resource allocation, organizational efficiency.
Data Analysis: Statistical analyses for differences and correlations; descriptive statistics; comparative analyses for regional disparities; multivariate regression for access to care impact on quality of life and costs.
Ethical Considerations: Conducted per ethical guidelines; informed consent obtained; data confidentiality maintained.
Regional Disparities in Access to Care:
Northern regions (Lombardy, Emilia-Romagna) have shorter waiting times and more innovative therapies compared to southern regions (Calabria, Sicily).
Quality of Life:
Patients with better access to care (Lombardy) have lower HAQ scores (0.5) compared to patients with poor access (Calabria, HAQ score of 1.2).
Healthcare Costs:
Direct costs are higher in advanced regions, while indirect costs are higher in regions with poor access to care.
Multidisciplinary Care Models:
Regions like Emilia-Romagna show better outcomes and reduced waiting times due to improved coordination.
Digital Technologies:
Telemedicine reduces waiting times and improves access in remote areas, more prevalent in advanced regions.
Patient and Healthcare Provider Feedback:
Greater satisfaction in regions with better access to care, timely interventions, and integrated care pathways are appreciated.
Conclusion: The analysis of access to care for RA and PsA patients shows significant regional disparities within the Italian healthcare system. These disparities lead to unequal access to therapies, prolonged waiting times, and inconsistent care quality, impacting patients’ overall health and quality of life. To address these issues, a strategic approach is needed, focusing on standardizing Diagnostic-Therapeutic Care Pathways (PDTA), implementing multidisciplinary care models, and extensively using digital technologies like telemedicine. Standardization ensures uniform care across the country, while multidisciplinary models enhance care continuity and effectiveness. Digital technologies help overcome geographical barriers and improve service access. Coordinated efforts among healthcare institutions, patient associations, and policymakers are crucial to reducing inequalities, optimizing resources, and promoting therapeutic innovations. Through an inclusive and proactive approach, equitable, accessible, and personalized care for all RA and PsA patients can be achieved, improving clinical outcomes and sustaining the National Health System.
REFERENCES: [1] Johnson, A., & Roberts, L. (2019). Regional Disparities in Access to Rheumatologic Care.
Journal of Rheumatology, 47(2
), 123-135.
[2] World Health Organization. (2021). Rheumatoid Arthritis Facts. World Health Organization.
[3] Italian Ministry of Health. (2022).
Equity of Access to Care: The Italian Healthcare System
. Italian Ministry of Health.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (