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Int. J. Environ. Res. Public Health 2014, 11(12), 12848-12865; doi:10.3390/ijerph111212848

Addressing Health Disparities in Chronic Kidney Disease

1
Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City 115, Taiwan
2
The Institute of History and Philology, Academia Sinica, Taipei City 115, Taiwan
3
Institute of Taiwan History, Academia Sinica, Taipei City 115, Taiwan
4
Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei City 106, Taiwan
5
Institute of Population Health Sciences, National Health Research Institutes, Miaoli County 350, Taiwan
*
Author to whom correspondence should be addressed.
Received: 19 August 2014 / Revised: 21 November 2014 / Accepted: 3 December 2014 / Published: 11 December 2014
(This article belongs to the Special Issue Proceedings from 2014 Global Land Project (GLP) Asia Conference)
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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. View Full-Text
Keywords: chronic kidney disease; health disparity; prevalence; spatial analysis; geographic information systems chronic kidney disease; health disparity; prevalence; spatial analysis; geographic information systems
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Chan, T.-C.; Fan, I.-C.; Liu, M.S.-Y.; Su, M.-D.; Chiang, P.-H. Addressing Health Disparities in Chronic Kidney Disease. Int. J. Environ. Res. Public Health 2014, 11, 12848-12865.

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