Addressing health disparities in chronic kidney disease
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...
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| Veröffentlicht in: | International journal of environmental research and public health 2014-12, Vol.11 (12), p.12848-12865 |
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| creator | Chan, Ta-Chien Fan, I-Chun Liu, Michael Shi-Yung Su, Ming-Daw Chiang, Po-Huang |
| description | 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. |
| doi_str_mv | 10.3390/ijerph111212848 |
| format | Article |
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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.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph111212848</identifier><identifier>PMID: 25514144</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adolescent ; Adult ; Aged ; Cluster Analysis ; Female ; Geography ; Health Status Disparities ; Hemodialysis ; Humans ; Incidence ; Information systems ; Kidney diseases ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - etiology ; Male ; Medical research ; Middle Aged ; Prevalence ; Public health ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - etiology ; Risk Factors ; Taiwan - epidemiology ; Young Adult</subject><ispartof>International journal of environmental research and public health, 2014-12, Vol.11 (12), p.12848-12865</ispartof><rights>Copyright Molecular Diversity Preservation International Dec 2014</rights><rights>2014 by the authors; licensee MDPI, Basel, Switzerland. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c520t-cf732bc9b4fbd23244d0289bc1e9c6f781f7413ee8cde965d4b2f9bc36a699283</citedby><cites>FETCH-LOGICAL-c520t-cf732bc9b4fbd23244d0289bc1e9c6f781f7413ee8cde965d4b2f9bc36a699283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276650/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276650/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27915,27916,53782,53784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25514144$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Ta-Chien</creatorcontrib><creatorcontrib>Fan, I-Chun</creatorcontrib><creatorcontrib>Liu, Michael Shi-Yung</creatorcontrib><creatorcontrib>Su, Ming-Daw</creatorcontrib><creatorcontrib>Chiang, Po-Huang</creatorcontrib><title>Addressing health disparities in chronic kidney disease</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cluster Analysis</subject><subject>Female</subject><subject>Geography</subject><subject>Health Status Disparities</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Incidence</subject><subject>Information systems</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Public health</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Risk Factors</subject><subject>Taiwan - epidemiology</subject><subject>Young Adult</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkUtLAzEUhYMoWh9rdzLgxk1tHneSyUYo4gsKbnQdMskdJ3U6U5Op4L93ilWqK1c3cL4c7j2HkFNGL4XQdBLmGJc1Y4wzXkCxQ0ZMSjoGSdnu1vuAHKY0p1QUIPU-OeB5zoABjIiaeh8xpdC-ZDXapq8zH9LSxtAHTFloM1fHrg0uew2-xY-1ijbhMdmrbJPwZDOPyPPtzdP1_Xj2ePdwPZ2NXc5pP3aVErx0uoSq9FxwAE95oUvHUDtZqYJVCphALJxHLXMPJa8GWUgrteaFOCJXX77LVblA77Dto23MMoaFjR-ms8H8VtpQm5fu3QBXUuZ0MLjYGMTubYWpN4uQHDaNbbFbJbPOCIYo1X9QoUELpfSAnv9B590qtkMSAwUAeU6VGqjJF-Vil1LE6mdvRs26P_Onv-HH2fa5P_x3YeITglKXJw</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Chan, Ta-Chien</creator><creator>Fan, I-Chun</creator><creator>Liu, Michael Shi-Yung</creator><creator>Su, Ming-Daw</creator><creator>Chiang, Po-Huang</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7ST</scope><scope>7T2</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>SOI</scope><scope>5PM</scope></search><sort><creationdate>20141201</creationdate><title>Addressing health disparities in chronic kidney disease</title><author>Chan, Ta-Chien ; Fan, I-Chun ; Liu, Michael Shi-Yung ; Su, Ming-Daw ; Chiang, Po-Huang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c520t-cf732bc9b4fbd23244d0289bc1e9c6f781f7413ee8cde965d4b2f9bc36a699283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Cluster Analysis</topic><topic>Female</topic><topic>Geography</topic><topic>Health Status Disparities</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Incidence</topic><topic>Information systems</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Public health</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - etiology</topic><topic>Risk Factors</topic><topic>Taiwan - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Ta-Chien</creatorcontrib><creatorcontrib>Fan, I-Chun</creatorcontrib><creatorcontrib>Liu, Michael Shi-Yung</creatorcontrib><creatorcontrib>Su, Ming-Daw</creatorcontrib><creatorcontrib>Chiang, Po-Huang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Environment Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Environment Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Ta-Chien</au><au>Fan, I-Chun</au><au>Liu, Michael Shi-Yung</au><au>Su, Ming-Daw</au><au>Chiang, Po-Huang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Addressing health disparities in chronic kidney disease</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>11</volume><issue>12</issue><spage>12848</spage><epage>12865</epage><pages>12848-12865</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>25514144</pmid><doi>10.3390/ijerph111212848</doi><tpages>18</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Cluster Analysis Female Geography Health Status Disparities Hemodialysis Humans Incidence Information systems Kidney diseases Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - etiology Male Medical research Middle Aged Prevalence Public health Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - etiology Risk Factors Taiwan - epidemiology Young Adult |
| title | Addressing health disparities in chronic kidney disease |
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