Renal transplantation for Indigenous Australians: identifying the barriers to equitable access.
Loading...
Date
2003-10-08
Author(s)
Journal Title
Journal ISSN
Volume Title
Publisher
Affiliation(s)
(Cass) Menzies Sch. Hlth. Res./Coop. Res., Ctr. for Aboriginal and Trop. Health, Casuarina, North. Territ., Australia
(Cunningham, Wang, Hoy) Menzies School of Health Research, Casuarina, North. Territ., Australia
(Snelling) Royal Darwin Hospital, Darwin, North. Territ., Australia
(Cass) Menzies School of Health Research, PO Box 41096, Casuarina, North. Territ. 0811, Australia
(Cunningham, Wang, Hoy) Menzies School of Health Research, Casuarina, North. Territ., Australia
(Snelling) Royal Darwin Hospital, Darwin, North. Territ., Australia
(Cass) Menzies School of Health Research, PO Box 41096, Casuarina, North. Territ. 0811, Australia
Year
2003
Citation
Ethnicity and Health. Vol.8(2), 2003, pp. 111-119.
Journal
Ethnicity & Health
Conference name
Conference location
Grant information
Abstract
Objective. To assess Indigenous Australians' access to renal transplantation, compared with non-Indigenous Australians. To examine whether disparities are due to a lower rate of acceptance onto the waiting list and/or a lower rate of moving from the list to transplantation. Design. National cohort study using data from the Australian and New Zealand Dialysis and Transplant Registry. We included all end-stage renal disease (ESRD) patients under 65 years of age who started treatment in Australia between January 1993 and December 1998. We used survival analysis to examine the time from commencement of renal replacement therapy (RRT) to transplantation. We measured time from commencement of RRT to acceptance onto the waiting list (stage 1), and time from acceptance onto the waiting list to transplantation (stage 2). The main outcome measures were (1) acceptance onto the waiting list and (2) receipt of a transplant, before 31 March 2000. Results. Indigenous patients had a lower transplantation rate (adjusted Indigenous:non-Indigenous rate ratio 0.32, 95% CI 0.25-0.40). They had both a lower rate of acceptance onto the waiting list (adjusted rate ratio 0.50, 95% CI 0.44-0.57) and a lower rate of moving from the list to transplantation (adjusted rate ratio 0.50, 95% CI 0.38-0.65). The disparities were not explained by differences in age, sex, co-morbidities or cause of renal disease. Conclusions. Indigenous Australians face barriers to acceptance onto the waiting list and to moving from the list to transplantation. Further research to identify the causes could facilitate strategies to improve equity in transplantation.
PubMed ID
14671765 [https://www.ncbi.nlm.nih.gov/pubmed/?term=14671765]
Type
Article
Study type
Subjects
Organ transplantation