eP553 - Is Social Deprivation a More Important Factor Than Ethnicity for Health Inequalities Experienced by Perianal Fistula Patients?

Purpose/Background: Perianal fistula disease is a common occurrence across the population. Health inequalities are associated with increased prevalence of disease, however, little research has been done specifically analysing the impact of ethnicity and social deprivation status. These two aspects represent significant components of a patient’s socioeconomic status. Understanding prevalence and occurrence of perianal fistula disease in different patient populations allows improved diagnostic measures and can enable targeted treatments. The UK public health service aspires to deliver a fair and accessible system across the population. This study evaluates the success in achieving an impartial, attainable service for perianal fistula patients.Methods/Interventions: A prospective study examined perianal fistula patients from 2020-2023 was conducted at Guy’s & St Thomas’ Hospital. Patient characteristics such as demographics, ethnicity, postcode and engagement with post-operative follow up collected. Patients were asked to complete questionnaires about quality of life and faecal incontinence (SF-36, ICQ-BS, FI-QoL and St Mark’s continence score) prior and after surgical procedure. Index of Multiple Deprivation (IMD) was calculated and patients categorised into three groups. Patients also categorised into five ethnic groups White British/Irish (WB), White Other (WO), Asian (A), Black (B) and Mixed/Other (M). ANOVA and Kruskal-Wallis test used to compare patient characteristics between different ethnicity and between different deprivation groups.Results/Outcomes: A total of 227 patients were included in the study but only 148 patients were included in the data analysis due to incomplete data sets. There was no strong significance between the five ethnic groups and the variables analysed. WB patients had the highest occurrence of questionnaire drop out (55%), whereas there were no drop outs in the A patient cohort (0%). WO patients had more pre-operative investigations than A and B patients (p=0.52). Perianal fistulas were commonest in the most deprived patient cohort (n=116), and least in the low deprivation patient group (n=29). Patients in the high deprivation group had significantly more co-morbidities (p=0.05), and had almost significantly more women (p=0.07). Patients from low social deprivation were more likely to have had previous perianal fistula operations (72% versus 46%, p=0.18). Patient engagement post-operatively was equivocal across the lowest and highest patient deprivation groups (35%, 38% respectively).Conclusion/

Discussion: Patient experience overall did not vary across the different ethnic groups, indicating that minorities do not experience disparity in management of perianal fistula disease within the region. Health inequalities do exist between low and high social economic groups as patients from more affluent areas are more likely to have pre-operative investigations and likely to have had previous interventions. Understanding where these differences in health inequalities occur will allow for directed interventions to reduce disparities. Further research into long-term follow up is required.