Projecting the future: modelling Australian dialysis prevalence 2021–30
Dominic Keuskamp A B * , Christopher E. Davies A B , Georgina L. Irish A B C , Shilpanjali Jesudason A B C and Stephen P. McDonald A B CA Australia & New Zealand Dialysis & Transplant Registry, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.
B Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
C Central Northern Adelaide Renal & Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
Australian Health Review 47(3) 362-368 https://doi.org/10.1071/AH22291
Submitted: 22 December 2022 Accepted: 22 April 2023 Published: 16 May 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Objectives To project the prevalence of people receiving dialysis in Australia for 2021–30 to inform service planning and health policy.
Methods Estimates were based on data from 2011 to 2020 from the Australia & New Zealand Dialysis & Transplant (ANZDATA) Registry and the Australian Bureau of Statistics. We projected dialysis and functioning kidney transplant recipient populations for the years 2021–30. Discrete-time, non-homogenous Markov models were built on probabilities for transition between three mutually exclusive states (Dialysis, Functioning Transplant, Death), for five age groups. Two scenarios were employed – stable transplant rate vs a continued increase – to assess the impact of these scenarios on the projected prevalences.
Results Models projected a 22.5–30.4% growth in the dialysis population from 14 554 in 2020 to 17 829 (‘transplant growth’) – 18 973 (‘transplant stable’) by 2030. An additional 4983–6484 kidney transplant recipients were also projected by 2030. Dialysis incidence per population increased and dialysis prevalence growth exceeded population ageing in 40–59 and 60–69 year age groups. The greatest dialysis prevalence growth was seen among those aged ≥70 years.
Conclusion Modelling of the future prevalence of dialysis use highlights the increasing demand on services expected overall and especially by people aged ≥70 years. Appropriate funding and healthcare planning must meet this demand.
Keywords: ageing, chronic disease management, chronic kidney disease, dialysis, epidemiology, health services research, kidney failure, population health, registry.
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