Rheumatoid arthritis and its supervision in Ireland: a public sector management challenge

Proceedings of The 3rd International Conference on Advanced Research in Management, Economics and Accounting

Year: 2022



Rheumatoid arthritis and its supervision in Ireland: a public sector management challenge

Christina Kenny, Gerardine Doyle, Anushree Priyadarshini



Rheumatoid Arthritis (RA) is a complex disease affecting 1% of the global population. It is a financial burden on public healthcare systems due to the increased use of primary and secondary healthcare infrastructure. It presents a public sector management challenge in Ireland due to its need for multidisciplinary oversight. As its incidence is expected to increase it is vital the care pathway, its key actors and their associated roles are better understood. This will enable a better comprehension of where costs are coming from and how to reduce them. This study aimed to assess which healthcare personnel play a key role in RA management within Ireland’s primary and secondary healthcare pathways. Five patient vignettes based on exemplar RA patient types were used to conduct semi-structured interviews with every member of the primary (N=21) and secondary (N=13) pathway. The interview data was analysed and used to create process maps of each vignette. Results demonstrated that the disease was managed very differently between primary and secondary care settings. In primary care, allied healthcare professionals such as occupational therapists and physiotherapists played a major role in patient management. Contrastingly, in secondary care, specialist nurses and consultants led patient management. The study contributes by highlighting areas of unnecessary complexity, pathway inefficiencies and by comparing which of these management methods provides better value in terms of cost per healthcare outcome to enable optimisation of the care pathway and allow for the more accurate allocation of resources. The elimination of overlap in roles between healthcare professionals as well as drawing attention to tasks that could be automated have the potential to reduce costs.

keywords: chronic disease, healthcare, management, public health, public sector.