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Donegal going against the flow: Irish differences in long-term urinary catheterisation (LTC) rates in men with Benign Prostatic Hypertrophy (BPH).

Authors:

Rory Stewart ,

ICGPIE
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Karena Hanley

ICGPGB
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Abstract

Donegal is a geographically removed county on the northwest coast of Ireland. It is known to have high levels of social deprivation¹.

Feedback from both hospital and general practice (GP) colleagues indicate that there appears to be a high proportion of men in Donegal with long-term urinary catheters (LTCs).  There is a perceived difficulty accessing Urology services for public (GMS) patients in Donegal.

A retrospective analysis of Primary Care Reimbursement Service (PCRS) data (2013) was carried out which demonstrated:

Total urinary catheter insertions in men over 65 years of age (2013): Donegal 907 ; Kerry  282; Dublin South  33; Dublin West 28; Waterford 1612.

This gives a crude 2.55% rate for male GMS patients in Donegal greater than 65 years of age for urinary catheter insertions compared to Dublin South: 0.045% ;Waterford: 0.63 % ; NICE > 75yrs: 0.5%3.

For the patients sampled in Donegal, The average duration since 1st urinary catheter insertion was 53 months.  89% of the patients had been referred to Urology. The mean wait for Urology review was 43.75 months. The mean patient age was 80 years. (21%) were based in a nursing home and (79%) were in the community.

Differences in LTC rates in the population sampled in Donegal (Rural), Leinster (Urban) and Waterford (Suburban) were significant 1.41% (95% CI 1.0203 – 1.7958) (P < 0.0001) and 1.81% (95% CI 14840 – 2.1549) ( P < 0.0001) respectively.

For many reasons Donegal has struggled with service provision particularly in services like Urology. Could this anomaly in LTC rates be a useful parameter to measure the quality and provision of local health services?

References:

1- Available from:  http://census.cso.ie/areaprofiles/areaprofile.aspx?Geog_Type=CTY&Geog_Code=33

 2- Available from: http://www.hse.ie/eng/staff/PCRS/PCRS_Publications/PCRS_Statistical_Analyis_of_Claims_and_Payments_2013.pdf

3- Available from: https://www.nice.org.uk/guidance/cg2/documents/infection-control-second-consultation-full-guideline-section-32   

How to Cite: Stewart R, Hanley K. Donegal going against the flow: Irish differences in long-term urinary catheterisation (LTC) rates in men with Benign Prostatic Hypertrophy (BPH).. International Journal of Integrated Care. 2017;17(5):A263. DOI: http://doi.org/10.5334/ijic.3574
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Published on 17 Oct 2017.

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