Comparison of Pediatric and Internist Providers of Pediatric Rheumatology Care

Pediatric Rheumatologists Only (n = 20)Internists Involved in Care of Children (n = 78)Unadjusted P Value* Pediatric vs Internists Who Treat Children
Age distribution
 0–5 y20.00.0<.001
 6–11 y30.04.5<.001
 12–15 y32.5 (9.84)33.6 (22.59)NS
 16–17 y16.4 (9.77)52.4 (27.73)<.001
Disease distribution among pediatric patients
 JRA41.5 (17.5)44.1 (31.3)NS
 SLE19.3 (13.6)23.0 (25.7)NS
 Pain syndromes7.51.0NS
 Other rheumatic disease11.55.0NS
 Rheumatic compliant with no diagnosis5.00.0NS
Comfortable treating
 JRA, systemic onset95.067.1.01
 JRA, pauciarticular100.080.8.04
 JRA, polyarticular100.080.8.04
 Kawasaki disease100.024.7<.001
 Polyarteritis Nodosa85.043.8.001
 Psoratic arthritis90.080.8NS
 Reflex sympathethic dystropy90.034.3<.001
 Rheumatic fever100.049.3<.001
 Psychogenic rheumatism90.030.1<.001
 Anterior knee syndrome85.050.7.005
 Wegener’s granulomatosis85.042.5.001
 Henoch-Schonlein purpura100.061.6.001
 Fever of unknown origin100.028.8<.001
 Back pain85.060.3.06
Reason for treating
 Personal expertiseN/A78.4N/A
 Patient preferenceN/A73.6N/A
 Distance to nearest pediatric rheumatologistN/A65.8N/A
 Lack of available appointmentN/A38.4N/A
 Inability to refer because of insuranceN/A31.9N/A
 Practice income considerationsN/A4.4N/A
Interested in obtaining advice from pediatric rheumatologistN/A71.4N/A
  • SLE indicates systemic lupus erythematosus.

  • * For dichotomous variables, statistical tests were performed using χ2 when all cell sizes were >5. When ≥1 cells were <5, a 2-sided Fisher exact test was used. For continuous variables, 2-sided t tests were performed without assuming equal variances. For nonnormally distributed variables (Shapiro-Wilks test < .05), Wilcoxon rank sum tests were used.

  • Medians are presented for variables with highly skewed distributions for one or both groups.