Gaps in Rheumatology: geographic and structural barriers to Rheumatology services in southern Argentina

Autores: Carolina Ayelén Isnardi, Celeste Sebastiano, Karin Kirmayr, Mariela Aldrover, Mónica Díaz, Roberto Báez, Laura Herrera, Raúl Paniego, Gabriela Caballero, Ariana Ringer, Carla Matellán, Ignacio Bazzalo, Oscar Fernández Carro, Alberto García, Guillermo De Olloqui, Adriana López Cabanillas, Ariana Gallo Ariana, Lorena Ayala, Fernanda Abadie, Marcelo Pavia, Marcos Méndez, Juan Quintero, Federico Panieg

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Introduction: Argentina is a large country with limited and unevenly distributed rheumatologic care. Objectives: to describe the geographic reach of rheumatologic care in southern Argentina and quantify the distance patients travel to access such care, along with healthcare coverage, care modalities, and the types of diseases observed. Materials and methods: Descriptive, observational, cross-sectional study. Characteristics of patient care were identified from all individuals seen in outpatient rheumatology consultations over a one-month period. Results: A total of 36 rheumatologists (only 2 pediatric) and 2 residents practice in the region, with a density of 1.22 per 100,000 inhabitants and 1.98 per 100,000 km2. A total of 867 weekly care hours were recorded across 77 consultation points located in 63 centers, of which only 13 were public hospitals. Most patients traveled short distances (median 4 km), although 12% traveled 20–100 km and 16.6% more than 100 km. This latter group made greater use of telemedicine and private clinics. Conclusions: Significant geographic and structural disparities in access to rheumatologic care were identified in southern Argentina, highlighting the scarcity of specialists and the long distances many patients must travel. Targeted strategies are needed to reduce these disparities.