Understanding and reducing inequalities in kidney health care and outcomes in Scotland KINDER Study - Kidney Inequalities: Needs, Data, Experiences, Response

Rzewuska Diaz M., Keskindağ B., Blakeman T., Cowan E., Hughes A., Sawhney S.(Yürütücü)

Diğer Ülkelerdeki Kamu Kurumları Tarafından Desteklenmiş Proje, 2024 - 2025

Proje Türü: Diğer Ülkelerdeki Kamu Kurumları Tarafından Desteklenmiş Proje
Başlama Tarihi: Şubat 2024
Bitiş Tarihi: Eylül 2025

Proje Özeti

The KINDER study aimed to advance understanding of kidney healthcare inequities in Scotland - moving beyond simply recognising that disparities exist, to uncovering their causes and identifying practical strategies to reduce their impact.

• This mixed methods study brought together innovative health data and Scottish Census linkages; patient and health professional experiences from across Scotland; and expert stakeholder workshops to identify strategies to mitigate inequities in early kidney care.

• Inequities in kidney health care and outcomes were evident across the clinical course but most pronounced at the earliest stage of kidney disease detection, among people of working age; and men. Quantitative analysis revealed intersectional disadvantages at neighbourhood, household, and individual levels. People in deprived communities were more likely to present late, missing opportunities for timely initiation of clinical course modifying treatments

• Qualitative interviews revealed that in deprived communities, early kidney care occurs late. People often discover it by accident and at an already advanced stage. With clinicians signaling low urgency, CKD rarely becomes a priority amid other pressing health and life problems. People then struggle to navigate a pressured primary-care system with limited CKD understanding, constrained resources, and uneven community biopsychosocial provision...

• Stakeholder workshops identified three priority areas for narrowing kidney inequities in Scotland from which 18 potentially feasible improvement activities were identified:

(1) improved messaging, (2) reducing practical barriers; (3) whole-person care