Effects of socioeconomic disadvantage on renal failure hospital admissions in Victoria.

Abstract

5 years of age. RFAs had the sixth highest 30-day readmission (15%). One-tenth of the patients died in hospital. The RFA rates varied inversely with SED (r=–0.51, P <0.01).Thecoefficientofvariationwas0.44and0.16forRFA andalladmissions,respectively,indicatingthatRFAshadgreater variability by LGA than all admissions. The mean RFA rate for the top percentile LGAs was 2.4-fold greater than that of the bottom percentile LGA (13.21 (95% CI 11.44–14.93) vs 5.62 (95% CI 4.43–6.95), respectively). The top percentile group was the most disadvantaged, including Central Goldfields, Loddon and Mildura. The bottom percentile group include Bayside, Boroondara and Nillumbik. LGAs with high RFA rates also had high hospital admission ratesforotherconditions,suchasheartfailure(r=0.58,P <0.01) and chronic obstructive pulmonary disease (r=0.49, P <0.01), and prevalence of hypertension (r=0.32, P <0.01) and obesity (r=0.26,P <0.05). Residents of disadvantaged communities are significantly more likely (r=0.45, P <0.01) to be on a Disability Support Pension (Table 1). Inconclusion,thevariationsinRFAratesmayreflectmultiple factors, particularly access to adequate care, delayed referral to Table 1. Inter-correlation coefficients for age-standardised renal failure hospitalisation rates and key variables *P <0.05, **P <0.01 (two-tailed). SED, socioeconomic disadvantage; REN, age-adjusted renal failure admissions per 10 000 population; HRF, age-adjusted heartfailureadmissionsper10 000population;COP,age-adjustedchronicobstructivepulmonarydiseaseadmissionsper10 000population;OCA,proportionof thepopulationundertakingmostlyheavylabourorphysicallydemandingactivity;HYP,prevalence(%)ofhypertension;OBE,prevalence(%)ofoverweightand obesity;HLS,prevalence(%)offairorpoorself-reportedhealthstatus;CAN,prevalence(%)ofcancer;DSP,proportionofthepopulationonDisabilitySupport