RT Journal Article
SR Electronic
T1 Variation in waiting times by diagnostic category: an observational study of 1,951 referrals to a neurology outpatient clinic
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP e000133
DO 10.1136/bmjno-2021-000133
VO 3
IS 1
A1 Fran Biggin
A1 Timothy Howcroft
A1 Quinta Davies
A1 Jo Knight
A1 Hedley C A Emsley
YR 2021
UL http://neurologyopen.bmj.com/content/3/1/e000133.abstract
AB Objective To investigate the frequency of diagnoses seen among new referrals to neurology outpatient services; to understand how these services are used through exploratory analysis of diagnostic tests and follow-up appointments; and to examine the waiting times between referral and appointment.Methods Routine data from new National Health Service appointments at a single consultant-delivered clinic between September 2016 and January 2019 were collected. These clinical data were then linked to hospital administrative data. The combined data were assigned diagnostic categories based on working diagnoses to allow further analysis using descriptive statistics.Results Five diagnostic categories accounted for 62% of all patients seen within the study period, the most common of which was headache disorders. Following a first appointment, 50% of all patients were offered at least one diagnostic test, and 35% were offered a follow-up appointment, with variation in both measures by diagnostic category. Waiting times from referral to appointment also varied by diagnostic category. 65% of patients with a seizure/epilepsy disorder were seen within the 18-week referral to treatment target, compared with 38% of patients with a movement disorder.Conclusions A small number of diagnostic categories account for a large proportion of new patients. This information could be used in policy decision-making to describe a minimum subset of categories for diagnostic coding. We found significant differences in waiting times by diagnostic category, as well as tests ordered, and follow-up offered; further investigation could address causes of variation.Data may be obtained from a third party and are not publicly available. Due to patient data confidentiality and restrictions imposed by the HRA, we are unable to directly share the data for this study. Anyone wishing to access this data must apply to do so through the HRA by completing an IRAS application.