Urban disadvantage and delayed nephrology referral in Australia.
This paper explores the relationship between area level measures of social disadvantage and the late referral of patients with end-stage renal disease (ESRD) to a nephrologist. Patients who were referred late were those who needed to commence dialysis within 3 months of referral to a nephrologist. Late referral has been associated with increased morbidity and mortality. We studied 3334 patients who started ESRD treatment in Australian capital cities between 1 April 1995 and 31 December 1998. The proportion referred late varied between areas, was higher in areas of greater disadvantage and was significantly related to the age- and sex-standardised incidence of ESRD. This may indicate inequitable access to optimal pre-ESRD care.
Cass
Alan
A
Menzies School of Health Research, P.O. Box 41096, Casuarina, NT 0811, Australia. alancass@menzies.edu.au
Cunningham
Joan
J
Snelling
Paul
P
Wang
Zhiqiang
Z
Hoy
Wendy
W
D001315:Australia / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D012017:Referral and Consultation; D012042:Registries; D012923:Social Class; D013997:Time Factors; D014505:Urban Population