Addressing health disparities in chronic kidney disease
Journal
International Journal of Environmental Research and Public Health
Journal Volume
11
Journal Issue
12
Pages
12848-12865
Date Issued
2014
Author(s)
Abstract
According to the official health statistics, Taiwan has the highest prevalence of end stage renal disease (ESRD) in the world. Each year, around 60,000 ESRD patients in Taiwan consume 6% of the national insurance budget for dialysis treatment. The prevalence of chronic kidney disease (CKD) has been climbing during 2008–2012. However, the spatial disparities and clustering of CKD at the public health level have rarely been discussed. The aims of this study are to explore the possible population level risk factors and identify any clusters of CKD, using the national health insurance database. The results show that the ESRD prevalence in females is higher than that in males. ESRD medical expenditure constitutes 87% of total CKD medical expenditure. Pre-CKD and pre-ESRD disease management might slow the progression from CKD to ESRD. After applying ordinary least-squares regression, the percentages of high education status and the elderly in the townships are positively correlated with CKD prevalence. Geographically weighted regression and Local Moran’s I are used for identifying the clusters in southern Taiwan. The findings can be important evidence for earlier and targeted community interventions and reducing the health disparities of CKD. ? 2014 by the authors; licensee MDPI, Basel, Switzerland.
Subjects
Chronic kidney disease; Geographic information systems; Health disparity; Prevalence; Spatial analysis
SDGs
Other Subjects
cluster analysis; disease prevalence; GIS; public health; risk factor; spatial analysis; adolescent; adult; age distribution; aged; Article; chronic kidney disease; controlled study; disease course; education; end stage renal disease; female; geographic distribution; health care access; health care cost; health care disparity; health insurance; help seeking behavior; human; major clinical study; male; prevalence; sex difference; social status; Taiwan; cluster analysis; geography; health disparity; incidence; Kidney Failure, Chronic; middle aged; Renal Insufficiency, Chronic; risk factor; young adult; Taiwan; Adolescent; Adult; Aged; Cluster Analysis; Female; Geography; Health Status Disparities; Humans; Incidence; Kidney Failure, Chronic; Male; Middle Aged; Prevalence; Renal Insufficiency, Chronic; Risk Factors; Taiwan; Young Adult
Type
journal article