Supplementary Material for: The Influence of Renal Centre and Patient Sociodemographic Factors on Home Haemodialysis Prevalence in the UK

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<p><b><i>Background:</i></b> In the United Kingdom, socioeconomic
disadvantage has been associated with lower use of home dialysis, mostly
peritoneal dialysis. In this study, we explore the role of a patient's
sociodemographic, socioeconomic differences and the centre's influence
on home haemodialysis (HD) prevalence. <b><i>Methods:</i></b> Data is
derived from the cross-sectional arm of the UK multi-centre study
investigating barriers and enablers of home HD (BASIC-HHD study).
Centres were classified as low- (<3%), medium- (5-8%) and
high-prevalence groups (>8%). Sociodemographic and socioeconomic
status data were ascertained. Patients were enrolled in hospital HD (<i>n</i> = 213), home HD (<i>n</i> = 93) and predialysis groups (<i>n</i> = 222). <b><i>Results:</i></b>
The treating renal centre to which the patient belonged was
significantly associated with a patient's modality in prevalent HD
groups and modality-choice in the “predialysis” group, in
confounder-adjusted multivariable analyses. Non-white ethnicity was
associated with lower odds of self-care dialysis modality choice (OR
0.21, 95% CI 0.07-0.62) and lower odds of home HD uptake in the
prevalent HD group (OR 0.24, 95% CI 0.07-0.80). Other significant
associations of home HD uptake in the HD cohort included lower age (OR
0.59, 95% CI 0.39-0.89), higher education (OR 2.99, 95% CI 1.25-7.16),
home ownership (OR 0.26, 95% CI 0.09-0.70), childcare responsibility (OR
0.22, 95% CI 0.08-0.66) and unrestricted mobility (OR 0.31, 95% CI
0.11-0.91). <b><i>Conclusion:</i></b> “Centre” effect accounts for
variation in home HD prevalence between renal units after accounting for
sociodemographic parameters and co-morbidities. Unit practices and
attitudes to home HD are likely to have a dominating impact on home HD
prevalence rates and these aspects need to be explored systematically at
the organisational level.</p>
Date made available8 Feb 2017
Publisherfigshare

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