In a recent study led by the University of East Anglia, researchers discovered significant disparities in the outcomes of patients with pulmonary fibrosis based on their socioeconomic status and proximity to healthcare facilities. The findings underscored that individuals from the most economically deprived areas experienced more severe symptoms upon hospital presentation and had lower survival rates compared to those from wealthier regions.
Using data from the British Thoracic Society Interstitial Lung Diseases Registry from 2013 to 2021, the study analysed 2,359 patients with idiopathic pulmonary fibrosis (IPF). It revealed that patients residing farthest from specialised respiratory clinics faced shorter life expectancies than those living nearer. Expressly, an unadjusted analysis indicated a 34% higher risk of mortality among those living further away, with a 29% increase even after adjusting for factors such as smoking, age, and time to referral.
Lead author Professor Andrew Wilson from UEA’s Norwich Medical School emphasised the unprecedented link between social deprivation, travel distance to hospitals, and survival rates for pulmonary fibrosis patients in the UK. He stressed the implications for healthcare planning, urging services to prioritise equitable access for geographically remote and socioeconomically disadvantaged individuals.
The research highlighted a stark reality: patients in the most deprived quintile faced a 36% higher risk of death compared to the least deprived, underscoring the critical impact of social factors on health outcomes. This disparity persisted even after accounting for various demographic and clinical variables, reaffirming the need for targeted interventions to address healthcare inequities.
Bradley Price, director of policy and public affairs at Action For Pulmonary Fibrosis, expressed concern over the healthcare disparities revealed by the study. He called for urgent reforms to ensure that access to timely diagnosis, treatment, and care is not determined by geographic location or socioeconomic status. He advocated for a more integrated regional approach to healthcare delivery.
The study’s findings also suggested potential strategies to mitigate these disparities, including targeted screening programmes and policies to improve access to specialist care for all patients, regardless of their socioeconomic background or geographical residence. However, the researchers stressed the necessity for further investigation to determine the effectiveness of localised care in enhancing survival rates and reducing diagnostic delays.
Alarmingly, the study revealed that 40% of patients experienced symptoms for more than two years before receiving specialist clinic referrals, indicating substantial delays in diagnosis and treatment initiation. This delay was coupled with high rates of respiratory symptoms reported among patients seen in primary care settings, highlighting the importance of raising awareness about IPF among healthcare providers at the primary level.
This research underscores the urgent need for healthcare reforms to address the disparities in survival and care access among pulmonary fibrosis patients based on socioeconomic status and geographic proximity to healthcare facilities. By implementing integrated care pathways and enhancing awareness and access at the primary care level, healthcare systems can improve outcomes and ensure equitable healthcare delivery for all individuals affected by chronic lung diseases like pulmonary fibrosis.
More information: Rashmi Shankar et al, Assessment of the impact of social deprivation, distance to hospital and time to diagnosis on survival in idiopathic pulmonary fibrosis, Respiratory Medicine. DOI: 10.1016/j.rmed.2024.107612
Journal information: Respiratory Medicine Provided by University of East Anglia
