eP325 - The Impact of Socioeconomic Status on Disparities in Pelvic Floor Disorders

Purpose/Background: Pelvic floor disorders (PFD) are common within the UK, however the variation in symptoms and engagement with services has not been compared across different Socioeconomic Status (SES). Each healthcare trust cares for patients across a range of SES. The objective of this study is to evaluate whether there are inequalities in treatment of patients with PFD based on the level of deprivation of their home location calculated with the Index of Multiple Deprivation score (IMD) which can be considered a parameter of the SES.Methods/Interventions: A retrospective study was conducted from 2013 to 2018 at Guy’s and St Thomas hospital, a tertiary referral centre for PFD. Patient demographics, symptoms, Consultant referral, biofeedback referral, diagnostics, Multidisciplinary meeting (MDM) outcomes, treatment received and review appointments were collected. Patients were categorized by the IMD score and put into quintiles of deprivation. Chi squared, ANOVA and Kruskal-Wallis were performed to establish associations between variables and SES.Results/Outcomes: A total of 2001 patients were identified, 9 patients were excluded due to incomplete data. In the highest quintiles there were mostly White British and Asian patients suggesting least deprivation. Ethnic minorities patients were more likely to be in the lowest quintiles. The age of patients increased with increasing quintile with males most prevalent in the lowest quintile. Patients of lowest quintiles were more likely to be referred to biofeedback (BFB) from Telephone Assessment Triage Clinic (TTAC) compared to highest quintiles patients (p=0.01). Highest quintiles patients were more likely to be referred to diagnostic tests from TTAC compared to lowest quintiles patients (p=0.001). Diagnostic tests, discussion in multidisciplinary meeting (MDM), Consultant review and surgical treatments were significantly less in the two lowest quintiles (p < 0.001, p < 0.001, p=0.02, p=0.02). Conservative treatment did not vary between deprivation groups. Patients of highest quintiles were more likely to complete the entire cycle of care and to be discharge to the general practitioner.Conclusion/

Discussion: This study has identified a relation between level of deprivation and management of care for PFD. People who live in more deprived areas are treated differently compared to people belonging to higher SES especially in terms of Consultant review and surgeries performed. This study allows for replication of service provision frameworks in other affected areas to minimise inequalities.