Patient non-attendance at urgent referral appointments for suspected cancer and its links to cancer diagnosis and one year mortality : A cohort study of patients referred on the Two Week Wait pathway
| Autor: | Philip Melling, Geoff Hall, Denise Denton, Sarah Forbes, Una Macleod, Peter Knapp, Edward Bolton, Victoria Allgar, Trish Green, Karl Atkin, Steven E. Oliver, Rebecca Sheridan |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Cancer Research Pediatrics medicine.medical_specialty No-Show Patients Time Factors Urgent referral Referral Epidemiology Cohort Studies One year mortality Appointments and Schedules 03 medical and health sciences Quality and Outcomes Framework 0302 clinical medicine Neoplasms Ambulatory Care medicine Humans 030212 general & internal medicine business.industry Attendance Cancer Middle Aged medicine.disease Survival Analysis Oncology 030220 oncology & carcinogenesis Female Patient Non-Attendance business Cohort study |
| ISSN: | 1877-7821 |
| Popis: | Background The ‘Two Week Wait’ policy aims to ensure patients with suspected cancer are seen within two weeks of referral. However, patient non-attendance can result in this target being missed. This study aimed to identify predictors of non-attendance; and analyse the relationship between attendance and outcomes including cancer diagnosis and early mortality. Methods A cohort study of 109,433 adults registered at 105 general practices, referred to a cancer centre within a large NHS hospital trust (April 2009 to December 2016) on the ‘Two Week Wait’ pathway. Results 5673 (5.2%) patients did not attend. Non-attendance was largely predicted by patient factors (younger and older age, male gender, greater deprivation, suspected cancer site, earlier year of referral, greater distance to the hospital) over practice factors (greater deprivation, lower Quality and Outcomes Framework score, lower cancer conversion rate, lower cancer detection rate). 10,360 (9.6%) patients were diagnosed with cancer within six months of referral (9.8% attending patients, 5.6% non-attending patients). Among these patients, 2029 (19.6%) died within 12 months of diagnosis: early mortality risk was 31.3% in non-attenders and 19.2% in attending patients. Conclusions Non-attendance at urgent referral appointments for suspected cancer involves a minority of patients but happens in predictable groups. Cancer diagnosis was less likely in non-attending patients but these patients had worse early mortality outcomes than attending patients. The study findings have implications for cancer services and policy. |
| Databáze: | OpenAIRE |
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