癌症中的不平等 两周的等待转诊:英语通用诊所的横截面研究
Stephanie C Wynne1, Mark Ashworth2
1Physiotherapy department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom steph.wynne@gstt.nhs.uk.
BJGP open
|January 8, 2025
概括
更高的癌症存活率与两周等待 (2WW) 转诊有关. 这项研究发现患者人口统计学和实践因素影响2WW转诊率,揭示了某些群体的潜在健康不平等.
科学领域:
- 在瘤学瘤学.
- 一般实践 一般实践
- 医疗保健服务研究 医疗服务研究
背景情况:
- 两周等待 (2WW) 转诊率与改善的癌症存活率有关.
- 目前,关于影响二维制药推率和潜在的健康不平等因素的证据有限,特别是在COVID-19后.
研究的目的:
- 确定患者因素 (年龄,性别,种族,贫困) 和实践因素 (远程咨询,GP连续性),这些因素可以独立预测2WW转诊率.
- 在不同癌症类型和人口群体中探索2WW转诊率的变化.
主要方法:
- 采用6307个英语普通实践 (2021-2022) 的数据进行的横截面观察性研究.
- 多变量线性回归分析以确定所有癌症和特定癌症 (乳腺癌,下肠道癌,肺癌,皮肤癌) 的2WW转诊率的独立预测因素.
主要成果:
- 对所有癌症的2WW转诊率更高与为更多女性,老年患者 (75岁以上) 和患有更长期疾病的患者提供服务的实践有关,并且患者参与护理决策的比例更高.
- 具有更高GP连续性的实践 (看到首选的GP) 显示了更少的癌症2WW转诊.
- 目前吸烟者和亚裔和黑人族裔患者比例较高,与所有癌症的2WW转诊数量较少有关,最显著的是皮肤和乳腺癌.
- 增加的社会经济贫困预计仅肺癌的2WW转诊率较低.
结论:
- 分析了影响2WW转诊率的因素,突出了潜在的健康不平等.
- 吸烟者和亚裔和黑人族裔患者被确定为优先人口,他们可能需要进行干预,以改善获得初级保健的机会.
- 在一般实践中,共享决策可能是一个有价值的策略,以提高所有癌症的转诊率.
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