Dialysis attendance patterns and health care utilisation of Aboriginal patients attending dialysis services in urban, rural and remote locations

• Published in: BMC health services research 2022-02, Vol.22 (1), p.251-251, Article 251
• Main Authors: Gorham, Gillian, Howard, Kirsten, Cunningham, Joan, Lawton, Paul Damian, Ahmed, A M Shamsir, Barzi, Federica, Cass, Alan
• Format: Article
• Language: English
• Subjects: Australian aborigines; Delivery of Health Care; Demographic aspects; Health aspects; Hemodialysis; Humans; Medical care; Northern Territory - epidemiology; Patient Acceptance of Health Care; Patient outcomes; Renal Dialysis; Rural Health Services; Rural Population; Social aspects; Utilization
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-022-07628-9

Aboriginal people in the Northern Territory (NT) suffer the heaviest burden of kidney failure in Australia with most living in remote areas at time of dialysis commencement. As there are few dialysis services in remote areas, many Aboriginal people are required to relocate often permanently, to access treatment. Missing dialysis treatments is not uncommon amongst Aboriginal patients but the relationship between location of dialysis service and dialysis attendance (and subsequent hospital use) has not been explored to date. To examine the relationships between location of dialysis service, dialysis attendance patterns and downstream health service use (overnight hospital admissions, emergency department presentations) among Aboriginal patients in the NT. Using linked hospital and dialysis registry datasets we analysed health service activity for 896 Aboriginal maintenance dialysis patients in the NT between 2008 and 2014. Multivariate linear regression and negative binomial regression analyses explored the associations between dialysis location, dialysis attendance and health service use. We found missing two or more dialysis treatments per month was more likely for Aboriginal people attending urban services and this was associated with a two-fold increase in the rate of hospital admissions and more than three-fold increase in ED presentations. However, we found higher dialysis attendance and lower health service utilisation for those receiving care in rural and remote settings. When adjusted for age, time on dialysis, region, comorbidities and residence pre-treatment, among Aboriginal people from remote areas, those dialysing in remote areas had lower rates of hospitalisations (IRR 0.56; P