Miss RACHEL CUTTING1, Professor ANGELA WEBSTER1,2,3, Dr NICHOLAS CROSS4, Dr HEATHER DUNCKLEY5, Dr BEN BEAGLEHOLE6, Dr IAN DITTMER7, Dr JOHN IRVINE4, Dr CURTIS WALKER8, Ms MERRYN JONES9, Dr MELANIE WYLD1,3, Professor KATE WYBURN1,10, Dr NICOLE DE LA MATA1
1Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia, 2National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, Australia, 3Westmead Applied Research Centre, Westmead Hospital, Westmead, Australia, 4Department of Nephrology, Canterbury District Health Board, Christchurch Hospital, Christchurch, New Zealand, 5New Zealand Transplantation and Immunogenetics Laboratory, New Zealand Blood Service, Auckland , New Zealand, 6Department of Psychological Medicine, University of Otago, Christchurch, New Zealand, 7Auckland City Hospital, Auckland District Hospital Board, Auckland , New Zealand , 8Internal Medicine, Medical Council of New Zealand, Mid Central District Health Board, Wellington, New Zealand, 9Renal Services, Ballantyne House, Hawke’s Bay District Health Board, , New Zealand, 10Renal Unit, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Australia
Aim: ASSET aims to create a comprehensive data platform to systematically address whether people in Aotearoa have equitable access to best treatment for their kidney failure and other illnesses.
Background: Equitable delivery of health services for kidney failure remains a challenge. Previous international studies found access to transplantation was disproportionate based on geographic location, ethnicity, and sex. Data linkage can provide granular insight into individuals’ interaction with health systems and factors contributing to inequity in health service delivery.
Methods: Our study population included all people receiving kidney replacement therapy in ANZDATA, all people ever waitlisted for a kidney transplant in the New Zealand Blood Service and all living kidney donors in ANZLKD in New Zealand between 2006 – 2019. Deterministic data linkage using the National Health Index number was undertaken by the New Zealand Ministry of Health. Linked health data included hospital admissions, outpatient and emergency attendance, cancer diagnoses, mental health service activity, prescription medications and deaths.
Results: We linked 7,705 people with kidney failure, 6,292 people waitlisted for a kidney transplant and 917 living kidney donors. Corresponding health records included 651,657 hospitalisations, >1,000,000 outpatient attendance, 2965 cancer diagnoses, >1,000,000 prescriptions, 138,663 mental health service attendance and 8524 deaths. Initial exemplar projects using the ASSET data platform will examine the impact of health service design and social determinants of health on the kidney waitlist, impact of mental health upon kidney transplantation, and living kidney donor health service usage.
Conclusion: ASSET data platform facilitates multifaceted health services research, with a focus on health equity in New Zealand. Biannual re-linkage enables the inclusion of additional databases broadening the scope of research and promoting multidisciplinary collaboration.
Biography:
Rachel is a Research Officer at the Sydney School of Public Health, University of Sydney and a Registered Nurse. Her primary role at The University of Sydney is to assist academics with research projects, focussing on improving efficiency, quality and safety in organ procurement and access and equity to health services for those with kidney failure.