Clinical Scientist, Clinical Genetics Unit, Western General Hospital, Edinburgh, EH4 2XU.
Scott Med J. 2010 Feb;55(1):10-3. doi: 10.1258/RSMSMJ.55.1.10.
In some studies the establishment of specialist satellite clinics nearer to the homes of patients has resulted in increased referral and attendance rates, particularly amongst populations in lower socio-economic groups. We investigated the effect on these rates of establishing satellite genetic counselling clinics for families with paediatric conditions in South East Scotland.
Families offered appointments at a clinic at the regional paediatric hospital were compared with those offered appointments at a satellite clinic at a local district general hospital. Both groups of families were more socially deprived than the general population (regional clinic p < 0.001, satellite clinics p < 0.05), and in both groups attendance rate at first appointment was 88% and inversely related to social deprivation. There was no evidence of greater attendance amongst more deprived patients at the satellite clinics compared to the regional clinic.
Our study found no evidence that the establishment of satellite clinics for genetic counselling in South East Scotland increases attendance by families with paediatric conditions in lower socio-economic groups. This suggests that factors other than clinic location determine referral and attendance rates, and these may include understanding of the reason for referral and the advantage of attendance.
在一些研究中,在离患者家较近的地方设立专门的卫星诊所,可提高转诊率和就诊率,尤其是在社会经济地位较低的人群中。我们研究了在苏格兰东南部为儿科患者家庭设立卫星遗传咨询诊所对这些比率的影响。
在区域儿科医院诊所提供预约的家庭与在当地地区综合医院的卫星诊所提供预约的家庭进行了比较。两组家庭的社会贫困程度均高于一般人群(区域诊所 p < 0.001,卫星诊所 p < 0.05),且首次预约的就诊率均为 88%,且与社会贫困程度呈反比。在卫星诊所就诊的患者中,贫困程度较高的患者就诊率并没有比区域诊所更高。
我们的研究没有证据表明,在苏格兰东南部为遗传咨询设立卫星诊所可以提高社会经济地位较低的儿科患者家庭的就诊率。这表明,除了诊所位置外,还有其他因素决定了转诊和就诊率,这些因素可能包括对转诊原因的理解和就诊的好处。