Renal transplantation for Indigenous Australians: Identifying the barriers to equitable access

Cass, Alan, Cunningham, Joan, Snelling, Paul, Wang, Zhiqiang and Hoy, Wendy (2003) Renal transplantation for Indigenous Australians: Identifying the barriers to equitable access. Ethnicity & Health, 8 2: 111-119. doi:10.1080/13557850303562


Author Cass, Alan
Cunningham, Joan
Snelling, Paul
Wang, Zhiqiang
Hoy, Wendy
Title Renal transplantation for Indigenous Australians: Identifying the barriers to equitable access
Journal name Ethnicity & Health   Check publisher's open access policy
ISSN 1465-3419
1355-7858
Publication date 2003
Sub-type Article (original research)
DOI 10.1080/13557850303562
Volume 8
Issue 2
Start page 111
End page 119
Total pages 9
Editor Karl Atkin
Place of publication Basingstoke, United Kingdom
Publisher Carfax Publishing
Language eng
Subject 111701 Aboriginal and Torres Strait Islander Health
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.
Keyword Ethnic studies
Access
Medical ethics
Aboriginal health
Renal disease
Transplantation
Equity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Wed, 17 Oct 2007, 12:18:20 EST