S AHMED1, P LAWTON1, G GORHAM1, J HUGHES1, C O’HEHIR2, C FRANCIS2, T GOODHEW2, K PRICE2, A CASS1
1Menzies School Of Health Research, Nightcliff, Australia, 2Ernst & Young, Sydney, Australia
Aim: To explore the health outcomes of dialysis patients who are tenants of urban Northern Territory government (NTG) housing.
Background: There has been little research exploring the health impacts of housing provision among dialysis patients from remote communities. The Dialysis Models of Care (DxMOC) Partnership inter-sectoral linked datasets (health to housing and education) enable the relationship between urban NT government housing tenure and health outcomes to be examined.
Methods: We used linked ANZDATA and NT hospitals data about 1360 patients receiving maintenance renal replacement therapy (RRT) between January 2000 to December 2015 inclusive, linked with urban NTG housing datasets (July 2001 to December 2015). Multivariable generalised estimating equations were used to estimate the risk of overnight hospitalisation and haemodialysis attendance for people with urban NTG housing tenancy, accounting for age, sex and Indigenous status.
Results: 222 (16.3%) RRT patients had at least one urban NTG housing allocation. 77% of them were from remote or very remote areas; 61.2% were female (p<0.05) and 94% were Indigenous (p<0.001). With multivariable analysis, tenants on haemodialysis were much less likely to have <11 haemodialysis sessions per 30 day period compared to those without urban NTG housing tenancy [odds ratio OR (95% CI), 0.55 (0.51-0.59)] The chances of overnight hospitalisation during urban NTG housing tenancy was no different for tenants compared to those without urban NTG housing tenancy [OR 0.97 (95% CI 0.91-1.04)].
Conclusions: Provision of urban public housing in the NT appears to be associated with higher haemodialysis attendance, without any difference in the chances of hospitalisation.
Dr Paul Lawton is a kidney specialist who has been working as a clinician across the Northern Territory since 1999, including four years as Director of Northern Territory Renal Services.
In his research, he addresses questions about kidney disease care disparities and outcomes among Indigenous Australians, using larger already existing datasets, including some data linkage. How can we do better for disadvantaged populations, and why aren’t we?