Chelsea and Westminster Hospital, London, UK
Airedale General Hospital, Keighley, UK.
Clin Med (Lond). 2022 May;22(3):241-245. doi: 10.7861/clinmed.2021-0716.
The multidisciplinary diagnostic clinic (MDC) model for 'non-specific' symptoms has been piloted in the UK. We aimed to assess the degree to which the MDC pathway was influenced by socioeconomic factors.
We collected data for all patients referred to the MDC from 01 January 2017 - 28 March 2019. Indices of multiple deprivation (IMD) scores were matched to patients' postcodes and referring general practitioner (GP) location. Socioeconomic data for MDC patients was compared with all other cancer patients diagnosed in the MDC's base hospital, Airedale General Hospital (AGH), in 2018. Statistical significance was tested using the Mann-Whitney test and Spearman's rank correlation.
No significant difference was found between MDC pathway and the rest of AGH when comparing social deprivation of patients.There was a moderate negative correlation between the IMD associated with the location of GP premises and the number of referrals; practices in more deprived locations referred fewer patients (p≤0.025).
The MDC pathway referral rate seems to be affected by social deprivation in a similar manner to other cancer diagnosis pathways. Our work highlights the importance of engaging GP practices with socially deprived populations as the MDC programme is rolled out across the UK.
英国已经试点了多学科诊断诊所（MDC）模式来诊治“非特异性”症状。我们旨在评估 MDC 路径在多大程度上受到社会经济因素的影响。
我们收集了 2017 年 1 月 1 日至 2019 年 3 月 28 日期间所有转诊至 MDC 的患者的数据。将多种剥夺指数（IMD）得分与患者的邮政编码和转诊全科医生（GP）所在地相匹配。将 MDC 患者的社会经济数据与 2018 年在 MDC 基地医院——艾尔代尔综合医院（AGH）诊断的所有其他癌症患者进行比较。使用曼-惠特尼 U 检验和斯皮尔曼等级相关检验来检验统计学意义。
在比较患者的社会剥夺程度时，MDC 路径与 AGH 的其余部分之间没有显著差异。GP 所在地的 IMD 与转诊数量之间存在中度负相关；在较贫困地区的诊所转诊的患者较少（p≤0.025）。
MDC 路径的转诊率似乎与其他癌症诊断途径一样受到社会剥夺的影响。我们的工作强调了在英国推出 MDC 计划时，与社会贫困人群中的 GP 实践合作的重要性。
