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Donegal Going against the Flow: National Differences in Long-Term Urinary Catheterisation Rates in Men (> 65 Years)

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Men in Donegal, Ireland, have significantly higher rates of long-term urinary catheter use compared to urban areas. This suggests potential disparities in accessing urology services, particularly for older men with medical cards.

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Area of Science:

  • Urology
  • Healthcare Access
  • Public Health

Background:

  • Primary Care Reimbursement Service (PCRS) data indicated disproportionately high urinary catheter changes in Donegal, Ireland.
  • A 60-fold difference in catheter change rates was observed between Donegal and South Dublin, prompting further investigation.

Purpose of the Study:

  • To investigate potential disparities in male long-term catheterisation (LTC) rates between rural Donegal and urban/suburban areas in Ireland.
  • To assess if observed differences in catheter changes reflect true differences in catheterisation prevalence.

Main Methods:

  • A survey of general practitioners was conducted in Donegal (rural), Leinster (urban), and Waterford (suburban).
  • Data on long-term catheter use was collected from 23,794 General Medical Services (GMS) patients across these regions.

Main Results:

  • Donegal showed 19 LTCs per 8603 GMS patients.
  • Leinster reported 4 LTCs per 5,800 GMS patients, and Waterford had 3 LTCs per 9,391 GMS patients.
  • These findings indicate a higher prevalence of LTCs in the rural Donegal population compared to urban and suburban areas.

Conclusions:

  • The higher prevalence of long-term catheters in Donegal suggests a potential proxy for reduced access to basic urology services in this region.
  • Further research is needed to confirm access issues and explore the underlying causes of these disparities.