Neale, Francesca K, Armstrong, Edward J, Cohen, Jonathan M et al. · Archives of disease in childhood · 2019 · DOI
This study looked at whether all children, regardless of their family's income level, had equal access to specialist hospital clinics in one UK hospital between 2007 and 2018. Researchers found that local outpatient clinics (like those for asthma and chronic fatigue syndrome) served children from all income levels fairly equally, but specialist tertiary clinics served more children from wealthier families. This suggests that some children may have better access to specialized care depending on where they live and their family's economic situation.
ME/CFS predominantly affects young people and often requires specialist diagnosis and management. This study demonstrates that access to tertiary paediatric care—where complex conditions like ME/CFS may be diagnosed—is inequitably distributed by socioeconomic status, meaning children from poorer families may face greater barriers to obtaining specialist evaluation and care for conditions like ME/CFS.
This study does not prove that deprivation causes differences in disease prevalence, nor does it establish whether unequal referral patterns reflect true differences in clinical need or represent a failure to recognize and refer affected children from deprived areas. It also does not demonstrate outcomes or quality of care received by different socioeconomic groups.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Neale, Francesca K, Armstrong, Edward J, Cohen, Jonathan M, Segal, Terry Y, & Hargreaves, Dougal S (2019). How fair is our service? Evaluating access to specialist paediatric care.. Archives of disease in childhood. https://doi.org/10.1136/archdischild-2019-317254
BibTeX
@article{mecfsatlas-neale-2019-how-fair,
author = {Neale, Francesca K and Armstrong, Edward J and Cohen, Jonathan M and Segal, Terry Y and Hargreaves, Dougal S},
title = {How fair is our service? Evaluating access to specialist paediatric care.},
journal = {Archives of disease in childhood},
year = {2019},
doi = {10.1136/archdischild-2019-317254},
note = {PubMed: 31300409},
url = {https://www.mecfsatlas.com/evidence/neale-2019-how-fair},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/neale-2019-how-fair
Contribute
Private, reviewed by a human. Not a public comment thread.