White P, James V, Ansell D, Lodhi V, Donovan K L
Cartographics Department, Welsh Assembly Government, Cardiff , UK.
QJM. 2006 Jul;99(7):445-52. doi: 10.1093/qjmed/hcl054. Epub 2006 May 8.
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.
To analyse access to current dialysis facilities in Wales, and use the data to help plan for new dialysis units.
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.
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.
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.
对透析的需求，尤其是中心血液透析（HD）的需求正在增长，因此将需要更多的透析单位。前往治疗地点的时间一直是患者主要关注的领域。
分析威尔士目前透析设施的可及性，并利用这些数据帮助规划新的透析单位。
我们分析了英国肾脏登记处、威尔士人口普查数据、2005年威尔士多重贫困指数（WIMD）、出行时间和地理信息系统的综合数据。
随着与透析单位距离的增加，血液透析的患病率显著下降。这不受WIMD的影响。在阿伯里斯特威斯的一个新血液透析单位开业之前，周边地区的患病率明显低于威尔士整体水平，但在两年内，患病率已上升至接近全国水平。在哈弗福德韦斯特，一个距离任何现有设施都超过30分钟车程的地区，患病率一直且显著低于威尔士整体水平，并且没有呈现出该国其他地区所出现的增长态势。
整合数据的能力使得能够对在哈弗福德韦斯特开设一个新单位可能产生的直接影响进行建模，同时也对其所需容量进行了估计。这种多学科的需求分析方法应有助于突出供应不足的领域，并促进威尔士新透析单位的选址和规模规划。
