Rheumatologists' quality of care for lupus: comparison study between a university and county hospital

Arthritis Care Res (Hoboken). 2012 Aug;64(8):1261-4. doi: 10.1002/acr.21653.


Objective: Quality of care received from physicians may impact health outcomes in systemic lupus erythematosus (SLE). We compared physician quality of care (P-QOC), health-related quality of life (HRQOL), and disease activity and damage between SLE patients receiving outpatient care at a university and a county rheumatology clinic.

Methods: Forty-two university and 41 county clinic SLE patients provided data on 5 P-QOC parameters and HRQOL health outcomes (Short Form 36 [SF-36] health survey and EuroQol 5-domain instrument [EQ-5D]). Disease activity and damage were measured. Chi-square analysis and Student's t-tests were used for comparisons.

Results: Overall satisfaction with medical care was similar; however, university patients had higher P-QOC scores than county patients in "perception of doctor's understanding of impact of SLE on patient's life" (P = 0.02) and "providing education/educational information to understand their disease" (P = 0.05). HRQOL, disease activity, and damage were similar in the 2 groups. Overall satisfaction with medical care was directly related SF-36 general health (r = 0.34, P = 0.03) and EQ-5D visual analog scale on state of health (r = 0.39, P = 0.01), and inversely related EQ-5D pain (r = -0.37, P = 0.02).

Conclusion: Patient perceptions of P-QOC differed across the 2 centers despite similar demographics, clinical and HRQOL outcomes, and significant overlap in the physicians serving each clinic. Patients' overall satisfaction with medical care is associated with better HRQOL.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Hospitals, County / standards*
  • Hospitals, University / standards*
  • Humans
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / epidemiology
  • Lupus Erythematosus, Systemic / therapy*
  • Male
  • Middle Aged
  • Physicians / standards*
  • Quality of Health Care / standards*
  • Rheumatology / methods
  • Rheumatology / standards*
  • Young Adult