The impact of deprivation on patients awaiting planned care-Reference-Cited by-同舟云学术

The impact of deprivation on patients awaiting planned care

Published:2022-10-01 Issue:10 Volume:3 Page:777-785
ISSN:2633-1462
Container-title:Bone & Joint Open
language:en
Short-container-title:Bone & Joint Open

Author:

Kulkarni Kunal¹^ORCID,Shah Rohi²^ORCID,Mangwani Jitendra²^ORCID,Dias Joseph²^ORCID

Affiliation:

1. Pulvertaft Hand Centre, University Hospitals of Derby and Burton NHS Trust, Derby, UK

2. Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK

Abstract

Aims Deprivation underpins many societal and health inequalities. COVID-19 has exacerbated these disparities, with access to planned care falling greatest in the most deprived areas of the UK during 2020. This study aimed to identify the impact of deprivation on patients on growing waiting lists for planned care. Methods Questionnaires were sent to orthopaedic waiting list patients at the start of the UK’s first COVID-19 lockdown to capture key quantitative and qualitative aspects of patients’ health. A total of 888 respondents were divided into quintiles, with sampling stratified based on the Index of Multiple Deprivation (IMD); level 1 represented the ‘most deprived’ cohort and level 5 the ‘least deprived’. Results The least deprived cohort were older (mean 65.95 years (SD 13.33)) than the most deprived (mean 59.48 years (SD 13.85)). Mean symptom duration was lower in the least deprived areas (68.59 months (SD 112.26)) compared to the most deprived (85.85 months (SD 122.50)). Mean pain visual analogue scores (VAS) were poorer in the most compared to the least deprived cohort (7.11 (SD 2.01) vs 5.99 (SD 2.57)), with mean mood scores also poorer (6.06 (SD 2.65) vs 4.71 (SD 2.78)). The most deprived areas exhibited lower mean quality of life (QoL) scores than the least (0.37 (SD 0.30) vs 0.53 (SD 0.31)). QoL findings correlated with health VAS and Generalized Anxiety Disorder 2-item (GAD2) scores, with the most deprived areas experiencing poorer health (health VAS 50.82 (SD 26.42) vs 57.29 (SD 24.19); GAD2: 2.94 (SD 2.35) vs 1.88 (SD 2.07)). Least-deprived patients had the highest self-reported activity levels and lowest sedentary cohort, with the converse true for patients from the most deprived areas. Conclusion The most deprived patients experience poorer physical and mental health, with this most adversely impacted by lengthy waiting list delays. Interventions to address inequalities should focus on prioritizing the most deprived. Cite this article: Bone Jt Open 2022;3(10):777–785.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Pharmacology (medical),Complementary and alternative medicine,Pharmaceutical Science

Link

https://online.boneandjoint.org.uk/doi/pdf/10.1302/2633-1462.310.BJO-2022-0037.R1

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