1Anzdata Registry, SAHMRI, Adelaide, Australia, 2Renal Unit, Royal Adelaide Hospital, Adelaide, Australia, 3University of Adelaide, Adelaide, Australia

Aim: Describe and plot geographical variation in ESKD incidence
Background: ESKD incidence in Australia has been well described in relation to clinical characteristics, but not geographic characteristics and spatial relationships.
Methods: Data from ABS and ANZDATA Registry data incident ESKD patients from 2012-16 were analysed to determine rates of new treated ESKD (dialysis and transplantation) in a geospatial framework. On the basis of residential postcodes, incidence rates overall and for various pre-defined sub-groups were determined for each statistical area level 3 (SA3 – typically 30-100,000 population). Detailed “heat maps” of ESKD incidence for Australia were created.
Results: Overall incidence was 116 per million per year (pmpy). The highest rates were noted in the Barkly region, NT (1058 [95% CI 732-1479] pmpy) ;  Alice Springs (973 [842-1118] pmpy)  and Katherine( 620 [479-791] pmpy). These “hot-spots” were associated with high proportions of Aboriginal and Torres Strait Islander population. Analyses restricted to non-indigenous populations revealed the areas of highest incidence were Biloela (Qld; 408 [95% CI 273-586] pmpy) followed by East Pilbara, Colac, Noosa and Goulbourn-Mulwaree. The highest absolute rates overall and for both indigenous and non-indigenous rates were in non-urban areas.
Conclusions: Linking of Registry information with geospatial data offers useful insights into disease patterns and service demands. Heat maps provide a powerful visual way of showing this data, and linking to other non-medical factors including community characteristics. In addition to SA3 areas, other potentially useful area for analysis include local government areas, “greater metropolitan” areas and hospital/health service catchment areas.

Prof Stephen McDonald is Director of Dialysis at the Central Northern Adelaide Renal and Transplantation Service, Clinical Director of Renal Services for Country Health SA and Executive Officer of the Australia and New Zealand Dialysis and Transplant Registry. He also is a Clinical Professor in the Adelaide Medical School, and Principal Research Fellow in the SA Health and Medical Research institute (SAHMRI).

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