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

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

Document type: Journal Article
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Title Renal transplantation for Indigenous Australians: Identifying the barriers to equitable access
Author Cass, Alan
Cunningham, Joan
Snelling, Paul L.
Wang, Zhiqiang
Hoy, Wendy E.
Journal Name Ethnicity and Health
Publication Date 2003
Volume Number 8
Issue Number 2
ISSN 1355-7858   (check CDU catalogue  open catalogue search in new window)
Start Page 111
End Page 119
Total Pages 9
Place of Publication England
Publisher Carfax
Language English
Field of Research 1117 - Public Health and Health Services
1608 - Sociology
1702 - Cognitive Sciences
HERDC Category C1 - Journal Article (DEST)
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.
Keywords Australians
indigenous
renal
transplantation
DOI http://dx.doi.org/10.1080/13557850303562   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 2602 (Journal)
 
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