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Age affects appointment chances | Age affects appointment chances |
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Age, sex and wealth all affect how likely your GP is to refer you for a specialist appointment, a study has concluded. | Age, sex and wealth all affect how likely your GP is to refer you for a specialist appointment, a study has concluded. |
A UK team analysed data for 130,000 patients, reporting their findings in the British Medical Journal. | A UK team analysed data for 130,000 patients, reporting their findings in the British Medical Journal. |
Older people were less likely to be referred for three common symptoms, with sex and deprivation also influential. | Older people were less likely to be referred for three common symptoms, with sex and deprivation also influential. |
A charity said the study should raise alarm bells across the NHS. | A charity said the study should raise alarm bells across the NHS. |
Michelle Mitchell, Charity Director at Age UK, said: "A doctor's decision to refer patients must be based solely on the patient's clinical need, not their age. Age discrimination in health provision will be unlawful from 2012 and it can't come a moment too soon for older people in need of medical care." | Michelle Mitchell, Charity Director at Age UK, said: "A doctor's decision to refer patients must be based solely on the patient's clinical need, not their age. Age discrimination in health provision will be unlawful from 2012 and it can't come a moment too soon for older people in need of medical care." |
The study from the King's Fund and University College London covered decisions on patients with postmenopausal bleeding, hip pain and heartburn from 326 UK practices across a six-year period. | The study from the King's Fund and University College London covered decisions on patients with postmenopausal bleeding, hip pain and heartburn from 326 UK practices across a six-year period. |
Once everything else that might influence a doctor's decision to refer - such as smoking, weight, alcohol use and pre-existing conditions - was taken into account, the researchers found significant differences in referral rates between old and young, male and female. | Once everything else that might influence a doctor's decision to refer - such as smoking, weight, alcohol use and pre-existing conditions - was taken into account, the researchers found significant differences in referral rates between old and young, male and female. |
As a guide, the older the patient, the less likely a referral was - in postmenopausal bleeding, someone aged 85 or over was 61% less likely to get a specialist appointment, compared with someone aged 55 to 64. | As a guide, the older the patient, the less likely a referral was - in postmenopausal bleeding, someone aged 85 or over was 61% less likely to get a specialist appointment, compared with someone aged 55 to 64. |
For patients with hip pain, the difference in referral rates was 32%. | For patients with hip pain, the difference in referral rates was 32%. |
Women were 10% less likely to be referred for hip pain than men, while there was some evidence that coming from a poorer background made a specialist appointment for hip pain and heartburn less likely. | Women were 10% less likely to be referred for hip pain than men, while there was some evidence that coming from a poorer background made a specialist appointment for hip pain and heartburn less likely. |
The reasons behind the decisions were not revealed by the study - however, the authors suggested that older patients might be less likely to ask for referral, and that GPs choosing to work in deprived areas might be generally less inclined to refer. | The reasons behind the decisions were not revealed by the study - however, the authors suggested that older patients might be less likely to ask for referral, and that GPs choosing to work in deprived areas might be generally less inclined to refer. |
However, they said that the differences could lead to "delays in treatment and poorer outcomes" - and might be an even greater concern if similar patterns emerged in referrals for other common symptoms, some of which could be linked to serious illness. | However, they said that the differences could lead to "delays in treatment and poorer outcomes" - and might be an even greater concern if similar patterns emerged in referrals for other common symptoms, some of which could be linked to serious illness. |
In an accompanying commentary, Professor Moyez Jiwa, from the Curtin Health Innovation Research Institute in Perth, Australia, said it was hard to know how harmful decisions like this could be. | In an accompanying commentary, Professor Moyez Jiwa, from the Curtin Health Innovation Research Institute in Perth, Australia, said it was hard to know how harmful decisions like this could be. |
While some patients might be "denied timely access" to experts, he wrote, others who were referred could be harmed by unnecessary testing and treatment. | |
He added: "The appropriate referral of cases has economic, quality and safety ramifications that resonate across the health sector and the globe." | |
Professor Jiwa said that database analysis like this could not help researchers understand why GPs and their patients behaved in a certain way in the consulting room. |
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