Socioeconomic deprivation, travel distance, and renal replacement therapy in the Trent Region, United Kingdom 2000: an ecological study
- R Maheswaran1,
- N Payne2,
- D Meechan3,
- R P Burden4,
- P R Fryers1,
- J Wight5,
- A Hutchinson3
- 1Public Health GIS Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
- 2North Eastern Derbyshire Primary Care Trust, Chesterfield, UK
- 3Section of Public Health, School of Health and Related Research, The University of Sheffield
- 4Renal Unit, Nottingham City Hospital, Nottingham, UK
- 5North Sheffield Primary Care Trust, Sheffield, UK
- Correspondence to: Dr R Maheswaran, Public Health GIS Unit, School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; r.maheswaran{at}sheffield.ac.uk
- Accepted 18 November 2002
The incidence of chronic renal failure rises with age and is higher in men and in people of Asian and Afro-Caribbean origin. A study using data from 1991–3 found that renal replacement therapy rates were related to age, ethnicity, socioeconomic deprivation, and travel distance to renal units.1 In the Trent Region, UK, which served a population of 5.1 million, a review of renal services was undertaken in 2000. We examined utilisation rates in relation to socioeconomic deprivation and travel distance to renal units as part of the needs assessment and planning process.
METHODS AND RESULTS
Patients in Trent Region who were receiving renal replacement therapy (haemodialysis, peritoneal dialysis, renal transplantation) in August/September 2000—that is, point prevalent cases—were categorised by enumeration district (ED), age band (15–24 to 80–84 years), and gender. (Data on acceptance of new patients were incomplete.) Data were obtained from renal units, including units outside Trent Region, which served patients resident in the Region. Corresponding 1991 census denominators, corrected for under-enumeration and scaled to 1998 Office for National Statistics mid-year estimates for the 11 health authorities in Trent, were obtained from an existing population dataset. The 1991 census based ED level Townsend score was categorised by quintile (with equal population in each category) and used as an indicator of socioeconomic deprivation.2 …
