1. Incidence and factors associated with geographical relocation in patients receiving renal replacement therapy
- Author
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Jenny H. C. Chen, Karumathil Murali, and Hicham I. Cheikh Hassan
- Subjects
Adult ,Male ,Rural Population ,Nephrology ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Urban Population ,medicine.medical_treatment ,Hemodialysis, Home ,lcsh:RC870-923 ,Health Services Accessibility ,White People ,Patient impact ,Cohort Studies ,Renal Dialysis ,Internal medicine ,medicine ,Humans ,In patient ,Renal replacement therapy ,Dialysis ,Aged ,Retrospective Studies ,Travel ,Geographic relocation ,Geography ,business.industry ,End stage kidney disease ,Incidence (epidemiology) ,Australia ,Retrospective cohort study ,Healthcare access ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,Kidney Transplantation ,Kidney Failure, Chronic ,Female ,Residence ,Relocation ,business ,Peritoneal Dialysis ,Research Article ,New Zealand ,Demography - Abstract
Background Renal replacement therapy (RRT) places a burden on patients, and geographical relocation for easier access to healthcare facilities is a necessity for some. Incidence and factors associated with relocation has not been comprehensively examined at a national level. We aimed to determine proportion, incidence, characteristics of RRT patients who relocate and relocation rate by remoteness of residence and dialysis modality. Methods Retrospective cohort analysis using Australian and New Zealand Dialysis and Transplant Registry to examine RRT patients in Australia from January 2005 to December 2015. Relocation incidence was calculated for remoteness of residence and RRT modality as rate per 100 patient years. Factors associated with relocation were examined using competing risk regression models with death as a competing event. Results Of 24,676 incident patients on RRT, 5888 (23.9%) relocated with a median time of 1.6 years [IQR 0.7–3.4] years. Relocation incidence was 7.9 per 100 patient years and increased from major cities to very remote regions (7.2 to 48.8 per 100 patient years respectively, p p = 0.034) and very remote regions (SHR 3.51 95% 3.05, 4.04 p p = 0.002) while transplant patients were less likely to relocate compared to haemodialysis patients (HR 0.37, 95%CI 0.34, 0.39, p Conclusions Relocation in patients receiving RRT is associated with remoteness of residence, RRT modality and ethnicity. Reasons for relocation and its impact on patient wellbeing and outcome should be further explored.
- Published
- 2020
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