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Individual factors contributing to the intercity patient mobility for chronic kidney diseases in China

  • WANG Fu-Lin ,
  • YANG Chao ,
  • LI Peng-Fei ,
  • WEN Feng-Yu ,
  • ZHANG Lu-Xia
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  • Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China;2National Institute of Health Data Science at Peking University, Beijing 100191, China; 3Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; 4Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; 5Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China

Received date: 2023-02-20

  Revised date: 2023-03-14

  Online published: 2023-05-12

Abstract

Objective  To explore the individual-level influencing factors of intercity mobility among adult patients with chronic kidney diseases (CKD) in China.  Methods   Based on a national hospitalization database of CKD inpatients from 2013 to 2018, descriptive statistics analysis and logistic regression were used to characterize the patient mobility for CKD and analyze the influencing factors.  Results  The overall proportion of intercity patient mobility for CKD was 17.73% in our study. There were significant differences in intercity mobility among patients with different causes of CKD (χ2=33582.873 P<0.001). In addition, the proportion of patient mobility was higher in rural area compared to urban (29.40% for rural and 12.30% for urban), especially for the intra-province mobility (24.69% for rural while 9.38% for urban). Other individual characteristics including age, sex, marriage, medical insurance and occupation also affect the mobility of CKD inpatients. To be specific, there is a decreasing tendency for intercity mobility with patients getting older (OR=0.982, 95% CI: 0.981~0.982, P<0.001); female patients are less likely to have intercity mobility behaviors than male patients (OR=0.934, 95%CI: 0.926~0.941, P<0.001); married patients are more likely to seek medical treatment across cities than unmarried patients (OR=1.045, 95%CI: 1.028~1.061, P<0.001); compared to patients with Urban Residents Basic Medical Insurance, patients with the New Rural Cooperative Medical Insurance have higher tendency for intercity mobility (OR=2.616, 95% CI: 2.585~2.647, P<0.001);in term of the patients’  occupation, taking workers as a reference, the professional and technical staff is more likely to have intercity mobility medical behaviors (OR=1.519, 95% CI: 1.473~1.566, P<0.001), while retired patients are less likely to do so (OR=0.894, 95%CI: 0.874~0.914, P<0.001).  Conclusions  There is a high mobility proportion of CKD inpatients in China, and the impact of non-medical factors on patient mobility should not be ignored. The results indicated that it is necessary to strength the guidance for reasonable medical behaviors on the basis of optimizing the layout of renal specialist resources.

Cite this article

WANG Fu-Lin , YANG Chao , LI Peng-Fei , WEN Feng-Yu , ZHANG Lu-Xia . Individual factors contributing to the intercity patient mobility for chronic kidney diseases in China[J]. Chinese Journal of Blood Purification, 2023 , 22(05) : 330 -334 . DOI: 10.3969/j.issn.1671-4091.2023.05.003

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