Determining the costs and benefits of dialysis services in urban, rural and remote settings – does place matter?

Project: HDR ProjectPhD

Project Details


Relocation for medical treatment is a common occurrence for people living in remote locations and particularly affects socially and economically disadvantaged populations. Aboriginal people in the Northern Territory suffer the highest burden of kidney disease in Australia and most live in remote areas where there is limited access to renal services. Long term relocation has enormous health and psychosocial impacts and is likely to have a cost impact on urban services. However, challenges also exist for the provision of dialysis services in remote areas including attraction and retention of skilled staff and high establishment and service delivery costs. Few studies have examined how treatment adherence, hospital admissions and emergency department presentations (and their associated costs), are influenced by a patient’s preference for services closer to home.
This study has:
1. Documented the history of renal service development in the NT, including key ministerial interventions and the persistent community advocacy for services closer to home.
2. Analysed linked clinical and administrative datasets to provide a comparative analysis of dialysis attendance by dialysis models of care (DxMoC) in urban, rural and remote locations and the factors influencing attendance and subsequent broader health service use.
3. Evaluated the capital and recurrent costs of dialysis service delivery by DxMoC.
4. Calculated the total expenditure associated with a DxMoC when all health service (hospitalisations and maintenance dialysis) costs were included and the incremental cost differences between DxMoC.
5. In partnership with all stakeholders (clinicians, policy makers and patients), developed a framework to assess the costs and benefits and value for money of a DxMoC when health outcomes, total health service costs and patients’ views are considered together.
Effective start/end date27/05/13 → …


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