Access to XXXX care in England, Wales and Northern Ireland: the effect of age, gender and weekend admission.

@entity1 @entity64
STUDY OBJECTIVES: To determine whether access to high-quality @entity64 care is affected by the age or gender of the @entity1 or by weekend admission. DESIGN: Data were collected as part of the National Sentinel Audit of @entity64 in 2004, both on the organisation of in- @entity1 @entity64 care and the process of care to hospitals managing @entity64 @entity1 . SETTING: Two hundred and forty-six hospitals from England, Wales and Northern Ireland took part in the 2004 National @entity64 Audit, a response rate of 100%. These sites audited te care of 8,718 @entity1 . AUDIT TOOL: Royal College of Physicians Intercollegiate Working Party @entity64 Audit Tool. RESULTS: Overall standards of care for cases of @entity64 in England, Wales and Northern Ireland are low. Older @entity1 are less likely to be treated in a @entity64 unit than younger @entity1 (risk ratio comparing 85 + years with those <65 years 0.82 (95% CI 0.75-0.90). Seventy-one per cent of @entity1 under 65 years were scanned within 24 h compared to 51% aged over 85 years. Older @entity1 were also less likely than younger ones to receive secondary prevention and some aspects of rehabilitation, especially around higher functioning. Standards were consistently better for @entity1 of all ages managed in @entity64 units compared to general wards. At weekends, @entity1 were less likely to be admitted directly to a @entity64 unit (risk ratio 0.77 95% CI 0.69-0.86) and brain imaging was performed less often for older (85 + years) @entity1 (weekday 56%, weekend 40%). There was little evidence of differences in standards of care between males and females. CONCLUSION: There is clear evidence of an age effect on the delivery of @entity64 care in England, Wales, and Northern Ireland, with older @entity1 being less likely to receive care in line with current clinical guidelines. Quality of acute care is also less good for @entity1 admitted at weekends. No systematic evidence for sexism was identified.
