Clinicians’ perspectives on equity of access to dialysis and kidney transplantation for rural people in Australia: a semistructured interview study

Scholes‐Robertson, Nicole; Gutman, Talia; Howell, Martin; Craig, Jonathan C.; Chalmers, Rachel M.; Dwyer, Karen M.; Jose, Matthew; Roberts, Ieyesha; Tong, Allison

doi:10.1136/bmjopen-2021-052315

Cited by 12 publications

(17 citation statements)

References 53 publications

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“…A phenomenological research method of qualitative research was adopted, and one-on-one interviews were conducted using a semi-structured interview method. As the most commonly used method for collecting qualitative research data, semi-structured interviews are relatively focused, do not deviate far from the topic, and can uncover a deep level of information [ 5 ]. An interview outline was developed before the interview, and the approval of the Ethics Committee was obtained.…”

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confidence: 99%

A qualitative study of psychological stress among China’s frontline nurses fighting COVID-19

Pan

Chen

et al. 2022

Arch Med Sci

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confidence: 99%

A qualitative study of psychological stress among China’s frontline nurses fighting COVID-19

Pan

Chen

et al. 2022

Arch Med Sci

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“…In this study the proportion of ethnic groups was Burmese (139/168), Rakhine (8/168), Karen (7/168), Shan identifi ed the importance of fi nancial hardships though HDC were supported by government [10]. Socio-economic equity was emphasized in fi ndings from Indonesia study; higher frequency of hemodialysis use wes directly aff ected by higher family income, distance < 20 km, working in informal sector, benefi ciary of government subsidy, longer duration of hemodialysis, severe condition of illness, and living in urban area [11].…”

Section: Resultsmentioning

confidence: 60%

“…The researchers from Australia found that geographical barriers were important in long term adherence [10]. Half of the patients required an hour travel time to HDC.…”

Section: Resultsmentioning

confidence: 99%

“…They also predicted that worldwide use of RRT would project to more than double to 5.439 million (3.899-7.640 million) people by 2030, with the most growth in Asia (0.968 million to a projected 2.162 million [1.571-3.014 million]) [9]. According to study on clinicians' perspectives from Australia, geographical barriers, dislocation from homes and fi nancial hardship were the major challenges for patients in accessing kidney replacement therapy in rural area [10].…”

Section: Introductionmentioning

confidence: 99%

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Equity of Maintenance Hemodialysis in Myanmar: Cross-Sectional Descriptive Study

Pyar¹,

Shwe²,

Lwin³

et al. 2022

J Biomed Res Environ Sci

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Background: Maintenance hemodialysis has been the commonest Renal Replacement Therapy (RRT) in Myanmar. The equity is questionable in Myanmar, a developing country, as developed countries reported inequities of dialysis in various aspects. Methods: A cross-sectional descriptive study was conducted in selected Hemodialysis Centers (HDC) which are under the care of government of Myanmar in August 2022. Data were collected by using standardized forms and analysis was done. Results: A total of 168 cases from 5 HDC situated in Yangon (lower part of Myanmar), Nay Pyi Taw (central part of Myanmar), Aung Ban (Eastern part of Myanmar), Lashio (North eastern part of Myanmar) and Kyaing Ton (near Golden Triangle) were included. The age range was 21-79 years; old age was not excluded for maintenance hemodialysis. Male to female ratio was 1:1.2 revealing accessibility of both sex to maintenance hemodialysis. The proportion of ethnic groups was Burmese (139/168), Rakhine (8/168), Karen (7/168), Shan (6/168), Danu (2/168), Paoh (1/168), Chin (1/168), Kachin (1/168), inlay (1/168), Lesue (1/168) and Larhu (1/168); it was in accordance with normal ethnic distribution in Myanmar. Regarding religion, the majority were Buddhist (158/168); Nine patients were Christian. One patient was Islam. It was proportionate with percentage of population by religion in 2014 Census. Only 38 patients were graduates and four patients were illiterate; therefore, illiterates were accessible to maintenance hemodialysis. Ninety-eight percent of patients had comorbidities; and, 5% had 5 comorbid diseases revealing patients with multiple comorbid status were not left behind. Half of the patients were unemployed pointing that the jobless were not excluded for hemodialysis. Median travel time to HD center was 45 minutes (IQR 26-120 minutes). The maximum was 3 hours (180 minutes) in 3 patients. Half of the patients required 60 minutes travel time to HDC. Fifty percent of patients had booster vaccination to COVID-19. Most of the patients, over 90%, were doing their daily routine activity without assistance. Ninety-eight percent of patients were satisfied with treatments in their corresponding HDC. Conclusion: There was no difference in age, sex, race, religion, comorbidity, employment status, underlying etiology and education in terms of accessibility to maintenance hemodialysis. Although they were dealing with long travel time of more than one hour in 50% of cases, their attitude was positive. As half of the patients had travel time of more than an hour, we need new HDC in Aung Ban. Resource allocation to renal replacement therapy should be encouraged at ministry level.

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“…Many barriers impede Aboriginal and Torres Strait Islander people who live with dialysis from accessing waitlisting, including slow or delayed assessments and referrals, cultural bias, misinformation, and the difficulties of distance (Box). 4‐9 …”

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confidence: 99%

Improving equity in access to kidney transplantation: implementing targeted models of care focused on improving timely access to waitlisting

Cundale,

McDonald,

Irish

et al. 2023

Medical Journal of Australia

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Improving equity in access to kidney transplantation: implementing targeted models of care focused on improving timely access to waitlisting K idney transplantation provides better quality and quantity of life for people with kidney failure. 1 However, of the 14% of all prevalent dialysis patients who identify as Aboriginal and Torres Strait Islander within the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, only 2% were waitlisted in 2021, compared with 8% of non-Indigenous patients who were waitlisted. 2 Equitably addressing this waitlisting gap was a significant priority of the National Indigenous Kidney Transplant Taskforce (NIKTT). 3 Many barriers impede Aboriginal and Torres Strait Islander people who live with dialysis from accessing waitlisting, including slow or delayed assessments and referrals, cultural bias, misinformation, and the difficulties of distance (Box). [4][5][6][7][8][9] The Commonwealth Department of Health and Aged Care awarded $1.3 million to the NIKTT to enable competitive project sponsorships for health care providers to develop models of care that promoted waitlisting attainment. All funded projects extended previously successful models of care to address contextspecific barriers to waitlisting and transplantation. These sponsorship projects were pilots of local care delivery that aimed to overcome context-specific barriers to kidney transplantation waitlisting. A more detailed evaluation of each of these projects will be available in the NIKTT's final report. 10 Here, we provide a commentary on elements of each project that acted as enablers or challenges, to better understand what could be scaled or used to improve services in the future. We outline the strategies used to overcome barriers, what was learned from the projects, and the implications for further practice change.

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Clinicians’ perspectives on equity of access to dialysis and kidney transplantation for rural people in Australia: a semistructured interview study

Cited by 12 publications

References 53 publications

A qualitative study of psychological stress among China’s frontline nurses fighting COVID-19

A qualitative study of psychological stress among China’s frontline nurses fighting COVID-19

Equity of Maintenance Hemodialysis in Myanmar: Cross-Sectional Descriptive Study

Improving equity in access to kidney transplantation: implementing targeted models of care focused on improving timely access to waitlisting

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