The influence of geography on uptake of plastic surgery services – analysis based on bilateral breast reduction data

Summary 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 with...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2010-04, Vol.63 (4), p.666-672
Main Authors: Nair, S, Richardson, E.A, Thompson, W.R.E, Shortt, N.K, Stewart, K.J
Format: Article
Language:English
Subjects:
Bilateral breast reduction
Biological and medical sciences
Catchment Area (Health)
Deprivation scores
Equitable health care
Female
Health Care Rationing - methods
Health Services Accessibility - statistics & numerical data
Hub-and-spoke model
Humans
Mammaplasty - methods
Mammaplasty - utilization
Medical sciences
Models, Theoretical
Plastic Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery, Plastic - utilization
Topography, Medical - methods
United Kingdom
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Summary:Summary 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.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2009.01.022