To compare quality of care (QoC), clinical outcomes, and patient-reported outcomes in multiple sclerosis (MS) clinics in Sweden.

QoC guidelines stipulate best practice in MS management, but are based on consensus opinion rather than evidence.

Retrospective observational cohort study. Data from the Swedish MS registry were linked to population registries. Included were adults with relapsing MS onset between 2001-201t. QoC metrics (time to diagnosis and treatment, visits in last 12, 24 and 36 months, MRI in last 12 months, proportion of patients receiving treatment) were obtained for all neurology clinics in Sweden. Clinic-level metrics in clinical outcomes (EDSS milestones and secondary progression) and patient-reported outcomes (MSIS and EQ5D) are described. We will present the effect of individual QoC indicators on outcomes, adjusting for clinical and socioeconomic confounders.

7790 patients from 64 clinics were included, 69% female. Median (IQR) number of patients per clinic was 54.50 (12.75, 135.25). Clinics’ median (IQR) time from onset to diagnosis was 260 days (212, 347.00), and onset to treatment was 357 days (292, 448.5). Clinics’ median (IQR) proportion of patients seen in the last 12 months was 0.65 (0.32, 0.83), and having MRI in the last 12 months was 0.33 (0.05, 0.65). Clinics’ median (IQR) proportion of patient-years on treatment was 0.41 (0.08, 0.64).

Clinics’ mean (SD) age at sustained EDSS 3 was 41.17 years (8.51). Clinics’ mean (SD) age at secondary progression was 50.04 (4.97). Clinics’ median (IQR) EQ5D general health score between 5-10 years' disease duration was 75.0 (70.0, 77.5). Clinics’ median (IQR) MSIS physical score between 5-10 years' disease duration was 14.0 (10.2, 17.4), psychological score was 22.0 (18.8, 26.3).

Neurology clinics differ in performance on QoC and clinical trajectories. Associations between specific quality metrics and outcomes, adjusted for clinical and socioeconomic confounders, will be presented.