Health inequalities in timely antenatal care: audit of pre- and post-referral delays in antenatal bookings in London 2015–16.

Background Antenatal booking has potential to reduce infant and maternal health inequalities; yet, those most in need are least likely to access timely care. This audit describes late referral and antenatal booking across London in 2015–16, according to maternal characteristics. Methods Referral < 8...

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Publicado en:Journal of Public Health Vol. 42; no. 4; pp. 801 - 816
Autores principales: McDonald, H, Moren, C, Scarlett, J
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Dec2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2020
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      pub: Oxford University Press / USA
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        atl: Health inequalities in timely antenatal care: audit of pre- and post-referral delays in antenatal bookings in London 2015–16.
      aug:
        au:
          McDonald, H
          Moren, C
          Scarlett, J
        affil: Antenatal and Newborn Screening , Public Health Commissioning Department, NHS England (London Region), London SE1 6LH, UK
      sug:
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          Prenatal Care England
          Appointments and Schedules
          Expectant Mothers
          Maternal Health Services
          Healthcare Disparities
          Health Services Accessibility
          Human
          Descriptive Statistics
          Data Analysis Software
          Female
          Young Adult
          Adult
          Social Determinants of Health
          England
          Adult: 19-44 years
          Female
      ab: Background Antenatal booking has potential to reduce infant and maternal health inequalities; yet, those most in need are least likely to access timely care. This audit describes late referral and antenatal booking across London in 2015–16, according to maternal characteristics. Methods Referral < 8 weeks' gestation, booking < 2 weeks after referral and booking < 10 weeks' gestation were audited against maternal and referral characteristics. Results Of 122 275 antenatal bookings, 27.1% were before 10 weeks' gestation and 72.8% by 12 + 6 weeks. Characteristics associated with late booking were living in more deprived areas, age < 20 years, higher parity, Black or Minority ethnicity (particularly Bangladeshi or Black African), birth in Somalia, Jewish religion, first language other than English, unemployment of self or partner, lack of social support, or single parent families. Women living in more deprived areas, with first language other than English, of Jewish religion, Black and Minority ethnicity or who were unemployed, waited longer from referral to booking, despite later referral. Conclusions Post-referral delays can compound late referral for some women, exacerbating health inequalities, but should be amenable to provider interventions. Different patterns of pre- and post-referral delay suggest that a tailored approach is needed to address inequalities in access to antenatal care.
      pubtype: Academic Journal
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        research
        tables/charts
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      ougenre: Article
    language: English
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