Reumatologia clinica · 2026
Pilgrimage of rheumatoid arthritis patients from the qom community through the healthcare system in two argentine provinces: A mixed-methods study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Quintana Rosana, Camacho Cecilia, Caamaño Milagros, Alvarez Marcela, Gomez Graciela, Oviedo Evelyn, Honeri Andrés, Vannucci Antonela, Calvo Maria Elena, Savarece Lorena, Pons-Estel Bernardo A, Pelaez-Ballestas Ingris, Valdata Marcela
Аннотация
OBJECTIVES: To describe and compare the health situation of rheumatoid arthritis (RA) patients from the qom community in the cities of Presidencia Roque Sáenz Peña (PRSP, Chaco Province) and Rosario (Santa Fe Province), focusing on access to the healthcare system and its limitations.
METHODS: A sequential mixed-methods approach was used. Quantitative phase: implementation of the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) methodology. Qualitative phase: ethnographic approach incorporating the concept of "healthcare pilgrimage".
RESULTS: Participants living in Rosario reported a higher intensity of pain (202 [42.9%] vs. 14 [11.0%], P < .0001), associated with a greater proportion of functional limitation according to the HAQ-DI score ≥0.8 (302 [64.1%] vs. 39 [30.2%], P < .0001). Among the diagnoses in PRSP, osteoarthritis was more prevalent than in Rosario (49 [10.1%] vs. 67 [4.0%], P < .0001), while RA prevalence was the same in both cities (12 [2.4%] vs. 40 [2.4%], P = .991). Three main topics emerged from the ethnographic analysis: pilgrimage within the healthcare system, barriers to specialized care, and access to treatment.
CONCLUSION: RA patients in both cities face significant challenges in navigating the healthcare system, underscoring their vulnerability. It is essential to adopt care models that integrate local knowledge and consider patients' mobility trajectories, ensuring access to and continuity of the treatments prescribed.
METHODS: A sequential mixed-methods approach was used. Quantitative phase: implementation of the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) methodology. Qualitative phase: ethnographic approach incorporating the concept of "healthcare pilgrimage".
RESULTS: Participants living in Rosario reported a higher intensity of pain (202 [42.9%] vs. 14 [11.0%], P < .0001), associated with a greater proportion of functional limitation according to the HAQ-DI score ≥0.8 (302 [64.1%] vs. 39 [30.2%], P < .0001). Among the diagnoses in PRSP, osteoarthritis was more prevalent than in Rosario (49 [10.1%] vs. 67 [4.0%], P < .0001), while RA prevalence was the same in both cities (12 [2.4%] vs. 40 [2.4%], P = .991). Three main topics emerged from the ethnographic analysis: pilgrimage within the healthcare system, barriers to specialized care, and access to treatment.
CONCLUSION: RA patients in both cities face significant challenges in navigating the healthcare system, underscoring their vulnerability. It is essential to adopt care models that integrate local knowledge and consider patients' mobility trajectories, ensuring access to and continuity of the treatments prescribed.