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How many patients with haematological malignancy need the facilities offered by a district general hospital?

How many patients with haematological malignancy need the facilities offered by a district general hospital?
How many patients with haematological malignancy need the facilities offered by a district general hospital?
Background: The objective of the study was to study the utilization of specialist clinical services for haematological malignancy in a defined patient population. Patients with haematological malignancy are mostly aged over 65 years. Demographic projections for the United Kingdom suggest that the incidence of haematological malignancy will increase by 20 per cent in the next 20 years, mostly as a result of demographic change.

Methods: A prevalence survey was carried out of out-patients with haematological malignancy resident in the New Forest area and their utilization of haematology clinical services at two sites.

Results: One hundred and ten patients (60 male, 50 female) were identified over three months: 87 (79 per cent) were aged over 65 years. Follow-up and therapy were carried out at a community hospital at Lymington, 19 miles from Southampton, in 83 patients (79 per cent, 45 male, 38 female, median age 74.9 years), and at one of two large hospitals in Southampton in 27 patients (21 per cent, 15 male, 12 female, median age 73.8 years). Attendance for more complex treatment at Southampton was necessary for 10 patients (9 per cent) in the Lymington group. Most interventions in both groups (356/379; 94 per cent) were basic, and were available and undertaken at either study site. Only 23/379 (6 per cent) of interventions required by the patient sample were more complex.

Conclusions: Most haematological malignancies are chronic disorders with a simple clinical management plan, requiring periodic clinical monitoring. A consultant-led haematology clinic supported by access to multipurpose day treatment facilities in the community hospital allowed 75 per cent of patients to receive their care at a more geographically convenient location, important for conditions in which 79 per cent of patients are aged over 65 years, and in which this proportion will increase. Only a minority of cases require care in specialist hospital haematology units; the majority can be managed using community-based haematological follow-up care. Future studies are needed to assess cost-effectiveness and the impact on primary care of increasing the use of community-based treatment facilities.
haematological malignancy, clinical haematology services, community hospital(s)
1741-3842
196-199
Low, Joe
29b70d2a-b0c1-4a8b-9183-18e99b3ec743
Smith, Alastair
60dc096d-d461-4991-9a80-b70106531b4f
George, Steve
bdfc752b-f67e-4490-8dc0-99bfaeb046ca
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Davis, Carol
2bc614b2-ba70-41bd-9d7e-9e1ca5b4ad5a
Low, Joe
29b70d2a-b0c1-4a8b-9183-18e99b3ec743
Smith, Alastair
60dc096d-d461-4991-9a80-b70106531b4f
George, Steve
bdfc752b-f67e-4490-8dc0-99bfaeb046ca
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Davis, Carol
2bc614b2-ba70-41bd-9d7e-9e1ca5b4ad5a

Low, Joe, Smith, Alastair, George, Steve, Roderick, Paul and Davis, Carol (2002) How many patients with haematological malignancy need the facilities offered by a district general hospital? Journal of Public Health, 24 (3), 196-199. (doi:10.1093/pubmed/24.3.196).

Record type: Article

Abstract

Background: The objective of the study was to study the utilization of specialist clinical services for haematological malignancy in a defined patient population. Patients with haematological malignancy are mostly aged over 65 years. Demographic projections for the United Kingdom suggest that the incidence of haematological malignancy will increase by 20 per cent in the next 20 years, mostly as a result of demographic change.

Methods: A prevalence survey was carried out of out-patients with haematological malignancy resident in the New Forest area and their utilization of haematology clinical services at two sites.

Results: One hundred and ten patients (60 male, 50 female) were identified over three months: 87 (79 per cent) were aged over 65 years. Follow-up and therapy were carried out at a community hospital at Lymington, 19 miles from Southampton, in 83 patients (79 per cent, 45 male, 38 female, median age 74.9 years), and at one of two large hospitals in Southampton in 27 patients (21 per cent, 15 male, 12 female, median age 73.8 years). Attendance for more complex treatment at Southampton was necessary for 10 patients (9 per cent) in the Lymington group. Most interventions in both groups (356/379; 94 per cent) were basic, and were available and undertaken at either study site. Only 23/379 (6 per cent) of interventions required by the patient sample were more complex.

Conclusions: Most haematological malignancies are chronic disorders with a simple clinical management plan, requiring periodic clinical monitoring. A consultant-led haematology clinic supported by access to multipurpose day treatment facilities in the community hospital allowed 75 per cent of patients to receive their care at a more geographically convenient location, important for conditions in which 79 per cent of patients are aged over 65 years, and in which this proportion will increase. Only a minority of cases require care in specialist hospital haematology units; the majority can be managed using community-based haematological follow-up care. Future studies are needed to assess cost-effectiveness and the impact on primary care of increasing the use of community-based treatment facilities.

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More information

Published date: September 2002
Keywords: haematological malignancy, clinical haematology services, community hospital(s)

Identifiers

Local EPrints ID: 24416
URI: http://eprints.soton.ac.uk/id/eprint/24416
ISSN: 1741-3842
PURE UUID: 466f6edc-20b4-439e-92a6-04d67418a0ea
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 31 Mar 2006
Last modified: 09 Jan 2022 02:47

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Contributors

Author: Joe Low
Author: Alastair Smith
Author: Steve George
Author: Paul Roderick ORCID iD
Author: Carol Davis

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