AbstractBackground: Evidence suggests that certain inequalities in care provision may result from differential access to services according to ethnic minority membership. Hearn (2006) identified that the Croydon Memory Service (CMS) showed good penetration into the local Black and Ethnic minority (BME) community. This audit aims to replicate Hearn’s aims and objectives with an updated data set; to investigate whether the range of referrals that the CMS receive continue to accurately reflect the ethnic composition of Croydon’s older adult population. In addition, the distribution pattern of diagnostic outcome across ethnic groups, the waiting time (between the receipt of referral and date of initial assessment) and the severity of cognitive impairment at initial presentation for seven ethnic groups will be considered.
Method: Information from 3264 referrals was utilised within the analysis, replicating and expanding upon Hearn’s (2006) methodology. Expected frequency data was calculated, categorised according to the self-report ethnicity labels available, and compared with the observed frequency data for the corresponding local population, using one-way classifications. Descriptive statistics are utilised to test the assumption that four categories of dementia (Alzheimer’s disease, Dementia in Alzheimer’s disease - mixed type, Vascular, Other Dementia Subtypes) - in addition to the outcomes of no diagnosis given and psychiatric-based diagnoses - would be distributed evenly across ethnic groups. The mean waiting times (in days) and mean MMSE scores at assessment were calculated and compared across superordinate ethnic groups by means of one-way ANOVA’s.
Results: Statistical analysis did not demonstrate a significant difference between the ethnic composition of the referrals assessed by the CMS and the Croydon data set. Waiting times did not differ across ethnic groupings. The mean MMSE scores obtained at assessment only differed significantly between the ‘White British - Black’ and ‘Black - Asian’ groups. Alzheimer’s was the most prevalent diagnosis observed across all ethnic groups within the sample; the remaining outcomes differ in proportion across groups.
Conclusions: These results indicate good penetration into local BME communities, demonstrating good practice and service equality across the different ethnic categories referred to the CMS. The results illustrate achievement of the standards created by the Memory Services National Accreditation Programme (MSNAP) and emphasise that the CMS provides a good prototype of what works in National Health Memory Services. The importance of a specialised service structure and liaison with both the community and primary care is highlighted, in order to increase access to BME communities.
|Date of Award
|Patrick Smith (Supervisor)