Disparities in testing for renal function in UK primary care: cross-sectional study

De Lusignan, Simon, Nitsch, Dorothea, Belsey, Jonathan, Kumarapeli, Pushpa, Vamos, Eszter Panna, Majeed, Azeem and Millett, Christopher (2011) Disparities in testing for renal function in UK primary care: cross-sectional study. Family Practice, 28(6), pp. 638-646. ISSN (print) 0263-2136

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Abstract

BACKGROUND: In the UK, explicit quality standards for chronic disease management, including for diabetes and chronic kidney disease (CKD), are set out National Service Frameworks and pay-for-performance indicators. These conditions are common with a prevalence of 4% and 5.4%, respectively. CKD is largely asymptomatic, detected following renal function testing and important because associated with increased mortality and morbidity, especially in people with diabetes and proteinuria. OBJECTIVES: To investigate who has their renal function tested and any association with age, sex, ethnicity and diabetes. METHOD: A cross-sectional survey in a primary care research network in south-west London (n = 220 721). The following data were extracted from routine data: age, gender, ethnicity, latest serum creatinine, diagnosis of diabetes and recording of proteinuria. We used logistic regression to explore any association in testing for CKD. RESULTS: People (82.1%) with diabetes had renal function and proteinuria tested; the proportion was much smaller (<0.5%) in those without. Women were more likely to have a creatinine test than men (28% versus 24%, P < 0.05), but this association was modified by age, ethnicity and presence of diabetes. People >75 years and with diabetes were most likely to have been tested. Black [adjusted odds ratio (AOR) 2.1, 95% confidence interval (CI) 2.0-2.2] and south Asian (AOR 1.65, 95% CI 1.56-1.75) patients were more likely to be tested than whites. Those where ethnicity was not stated were the only group not tested more than whites. CONCLUSIONS: Quality improvement initiatives and equity audits, which include CKD should take account of disparities in renal function testing.

Item Type: Article
Research Area: Computer science and informatics
Faculty, School or Research Centre: Faculty of Computing, Information Systems and Mathematics (until 2011)
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Depositing User: Automatic Import Agent
Date Deposited: 04 Jan 2012 14:57
Last Modified: 06 Jan 2012 14:54
URI: http://eprints.kingston.ac.uk/id/eprint/19730

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