QJM Advance Access originally published online on May 8, 2006
QJM 2006 99(7):445-452; doi:10.1093/qjmed/hcl054
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Equity of access to dialysis facilities in Wales
From the 1Cartographics Department, Statistical Directorate, Welsh Assembly Government, Cardiff, 2UK Renal Registry, Southmead Hospital, Bristol and 3University Hospital of Wales, Cardiff, UK
Address correspondence to Dr K.L. Donovan, University Hospital of Wales, Heath Park, Cardiff CF14 4XW. email: donovankl{at}cf.ac.uk
Received 14 December 2005 and in revised form 4 April 2006
Background: Demand for dialysis, particularly, in-centre haemodialysis (HD), is growing, and more units will be needed. Travel time to treatment is consistently a major area of concern for patients.
Aim: To analyse access to current dialysis facilities in Wales, and use the data to help plan for new dialysis units.
Methods: We analysed a combination of UK Renal Registry, Welsh population census data, the Welsh Index of Multiple Deprivation 2005 (WIMD), travel time and geographical information systems.
Results: Prevalence of HD fell significantly with increasing travel time from units. This was not influenced by the WIMD. Prior to the opening of a new HD unit in Aberystwyth, prevalence in the surrounding area was significantly lower than for Wales as whole, but within 2 years, prevalence had risen to approximate national levels. In Haverfordwest, an area >30 min drive from any current facility, prevalence is consistently and significantly lower than for Wales as a whole, and has not shown the growth seen elsewhere in the country.
Discussion: The ability to combine data has enabled modelling of the likely immediate impact of opening a new unit in Haverfordwest, and also provided an estimate of its required capacity. This multidisciplinary approach to demand analysis should help to highlight areas of under-provision, and facilitate the planning of the sites and sizes of new dialysis units in Wales.
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