The Influence of Geography and Socio-economics on Uptake of Plastic Surgery Services - Analysis Based on Bilateral Breast Reduction Data

S. Nair, Elizabeth Richardson, Niamh Shortt, K. J. Stewart, W. R. E. Thompson

Research output: Contribution to journalArticlepeer-review

Abstract

The hub-and-spoke model was introduced in the National Health Service (NHS) with the goal of providing equitable access to health care for all. This study uses bilateral breast reduction (BBR) surgery to assess the success of this model in delivering equity of access for plastic surgery within a publicly funded health-care system. This study also assessed the effect of socioeconomic deprivation on patients seeking BBR. The hospital records were used to identify all patients who underwent BBR at the St. John's Hospital between 1996 and 2005 (N = 1081). Patients living outside the catchment area were excluded.



Realistic travel distances and times to the hospital and clinics were calculated using patients' postcodes and geographic information systems (GIS) network analysis. Carstairs deprivation scores were obtained for the residential postcode of each patient. The main findings of this study are (1) accessibility to a plastic surgery clinic is an important factor in determining whether an eligible female patient undergoes BBR and (2) most deprived parts of the catchment area accounted for a significantly greater proportion of patients. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)666-672
Number of pages7
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume63
Issue number4
DOIs
Publication statusPublished - Apr 2010

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