Variations in U.K. Referral Patterns Examined

Severity of condition, presence of guidelines, and patient age all influential

WEDNESDAY, Dec. 1 (HealthDay News) -- Referral inequalities in the United Kingdom are more apparent for conditions that are not life threatening and when there is an absence of explicit guidelines, and for older patients, according to research published online Nov. 30 in BMJ.

Dulcie McBride, of the University College London, and colleagues compared referral rates in 5,492 patients with postmenopausal bleeding, 23,121 with hip pain, and 101,212 with dyspepsia, to examine the impacts of age, sex, and social deprivation on referral from primary care. They also examined what impacts the presence of national referral guidance and the potential of a symptom to be life threatening have on sociodemographic variations in referral.

The researchers found that 61.4 percent of patients with postmenopausal bleeding, 17.4 percent of those with hip pain, and 13.8 of those with dyspepsia were referred, and that referrals decreased with patients' increasing age. Referrals for hip pain and dyspepsia were also less frequent in people under 55 years of age who were of deprived status. The authors note that referral inequalities related to socioeconomic circumstances were most likely when explicit guidance and potentially life-threatening conditions were absent; however, they observed inequalities with age for all the conditions.

"The inequalities in referral observed could lead to delays in treatment and poorer outcomes. If our results extend to other symptoms, this would be of concern for serious conditions, some of which commonly present in non-specific ways, such as cancers of lung, colorectum, and ovary," the authors write.

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