Prevalence of socioeconomic deprivation and risk factors in patients on the elective surgery waiting list in the North East and North Cumbria region of England: a cross-sectional study.
Claire D Madigan, James Prentis, Edward Kunonga, Chris Snowden, Mackenzie Fong, Sophia Margarita Brady, Bob Gaffney, Eileen F S Kaner
Author Information
Claire D Madigan: Loughborough University, Loughborough, UK C.Madigan@lboro.ac.uk. ORCID
James Prentis: Department of Perioperative and Critical Care Medicine, Newcastle upon Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Edward Kunonga: North Cumbria Integrated Care Board, Carlisle, UK.
Chris Snowden: North Cumbria Integrated Care Board, Carlisle, UK.
Mackenzie Fong: Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.
Sophia Margarita Brady: Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK. ORCID
Bob Gaffney: NHS North of England Commissioning Support Unit, Durham, UK.
Eileen F S Kaner: Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.
OBJECTIVES: We examined the association of risk factors with socioeconomic deprivation in patients waiting for high volume low complexity (HVLC) surgical procedures in the North East and North Cumbria region. SETTINGS: We analysed data from the Rapid Actionable Insight Driving Reform database which links primary and secondary care elective waiting list data. PARTICIPANTS: Patients were included if they were waiting for HVLC surgery or an initial outpatient appointment for HVLC surgery. OUTCOMES: Smoking status, living with obesity, type 2 diabetes mellitus (T2DM), atrial fibrillation, chronic obstructive pulmonary disease (COPD), hypertension, serious mental illness or learning disability. Differences in outcomes by the England Index of Multiple Deprivation score quintiles were examined using ORs (95% CI). RESULTS: Of 78���571 patients, 30.6% were living in the most deprived quintile, 29.4% were living with obesity, 28.9% had hypertension and 13.5% were smokers. Though younger, 64.2% of patients in the most deprived quintile had at least one risk factor compared with 48% of patients in the least deprived quintile (OR 1.9 (95% CI 1.9, 2.0). The odds of being a smoker, living with obesity, T2DM, COPD and a serious mental illness or learning disability decreased as deprivation decreased in a dose-response relationship. CONCLUSIONS: People waiting for surgery from areas of greater deprivation are living with significantly more risk factors, and this may impact eligibility for surgery and surgical outcomes. Perioperative service provision must be delivered with deprivation in mind, otherwise health inequalities will be amplified.
