1. Identifying areas of need relative to liver disease: geographic clustering within a health service district.
- Author
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El-Atem, Nathan, Irvine, Katharine M., Valery, Patricia C., Wojcik, Kyle, Horsfall, Leigh, Johnson, Tracey, Janda, Monika, McPhail, Steven M., and Powell, Elizabeth E.
- Subjects
CHRONIC diseases ,CONFIDENCE intervals ,LIVER diseases ,MEDICAL needs assessment ,MULTIVARIATE analysis ,PROBABILITY theory ,RESEARCH funding ,DATA analysis software ,STATISTICAL models ,INTRACLASS correlation - Abstract
Background. Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods. The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results. During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions. The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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