Impact of geography on the control of XXXX : a review of geocoded clinical data from general practice.

@entity1 @entity102 @entity6 @entity4051
OBJECTIVE: To review the clinical data for @entity1 with @entity6 with reference to their location and clinical care in a general practice in Australia. MATERIALS AND METHODS: @entity1 data were extracted from a general practice in Western Australia. Iterative data-cleansing steps were taken. Data were grouped into Statistical Area level 1 (SA1), designated as the smallest geographical area associated with the Census of Population and Housing. The data were analysed to identify if SA1s with @entity1 aged 70   years and older, and with relatively high glycosylated haemoglobin (HbA1c) were significantly clustered, and whether this was associated with their medical consultation rate and treatment. The analysis included Cluster and Outlier Analysis using Moran's I test. RESULTS: The overall median age of the population was 70   years with more males than females, 53% and 47%, respectively. Older @entity1 (>70   years) with relatively high @entity4051 c comprised 9.3% of all @entity1 with @entity6 in the sample, and were clustered around two 'hotspot' locations. These 111 @entity1 do not attend the practice more or less often than @entity1 with @entity6 living elsewhere in the practice (p=0.098). There was some evidence that they were more likely to be recorded as having consulted with regard to other @entity102 . The average number of prescribed medicines over a 13-month time period, per @entity1 in the hotspots, was 4.6 compared with 5.1 in other locations (p=0.26). Their prescribed therapy was deemed to be consistent with the management of @entity1 with @entity6 in other locations with reference to the relevant @entity6 guidelines. CONCLUSIONS: Older @entity1 with relatively high HbA1c are clustered in two locations within the practice area. Their hyperglycaemia and ongoing cardiovascular risk indicates causes other than therapeutic inertia. The causes may be related to the social determinants of health, which are influenced by geography.
