Urban disadvantage and delayed nephrology referral in Australia

Health Place. 2003 Sep;9(3):175-82. doi: 10.1016/s1353-8292(02)00037-0.


This paper explores the relationship between area level measures of social disadvantage and the late referral of patients with end-stage renal disease (ESRD) to a nephrologist. Patients who were referred late were those who needed to commence dialysis within 3 months of referral to a nephrologist. Late referral has been associated with increased morbidity and mortality. We studied 3334 patients who started ESRD treatment in Australian capital cities between 1 April 1995 and 31 December 1998. The proportion referred late varied between areas, was higher in areas of greater disadvantage and was significantly related to the age- and sex-standardised incidence of ESRD. This may indicate inequitable access to optimal pre-ESRD care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia / epidemiology
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Incidence
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Referral and Consultation*
  • Registries
  • Social Class
  • Time Factors
  • Urban Population*