Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.
PLoS One. 2022 Aug 25;17(8):e0273371. doi: 10.1371/journal.pone.0273371. eCollection 2022.
Kidney transplantation is considered the ideal treatment for most people with kidney failure, conferring both survival and quality of life advantages, and is more cost effective than dialysis. Yet, current health systems may serve some people better than others, creating inequities in access to kidney failure treatments and health outcomes. AcceSS and Equity in Transplantation (ASSET) investigators aim to create a linked data platform to facilitate research enquiry into equity of health service delivery for people with kidney failure in New Zealand.
The New Zealand Ministry of Health will use patients' National Health Index (NHI) numbers to deterministically link individual records held in existing registry and administrative health databases in New Zealand to create the data platform. The initial data linkage will include a study population of incident patients captured in the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), New Zealand Blood Service Database and the Australia and New Zealand Living Kidney Donor Registry (ANZLKD) from 2006 to 2019 and their linked health data. Health data sources will include National Non-Admitted Patient Collection Data, National Minimum Dataset, Cancer Registry, Programme for the Integration of Mental Health Data (PRIMHD), Pharmaceutical Claims Database and Mortality Collection Database. Initial exemplar studies include 1) kidney waitlist dynamics and pathway to transplantation; 2) impact of mental illness on accessing kidney waitlist and transplantation; 3) health service use of living donors following donation.
The AcceSS and Equity in Transplantation (ASSET) linked data platform will provide opportunity for population-based health services research to examine equity in health care delivery and health outcomes in New Zealand. It also offers potential to inform future service planning by identifying where improvements can be made in the current health system to promote equity in access to health services for those in New Zealand.
肾移植被认为是大多数肾衰竭患者的理想治疗方法，既能提高生存率，又能提高生活质量，而且比透析更具成本效益。然而，目前的卫生系统可能对某些人更有利，从而导致获得肾衰竭治疗和健康结果的机会不平等。移植中的准入和公平性（ASSET）研究人员旨在创建一个链接数据平台，以促进对新西兰肾衰竭患者卫生服务提供公平性的研究。
新西兰卫生部将使用患者的国家健康指数（NHI）号码，通过确定性链接，将现有的登记和行政健康数据库中保存的个人记录链接起来，创建数据平台。最初的数据链接将包括 2006 年至 2019 年期间在澳大利亚和新西兰透析和移植登记处（ANZDATA）、新西兰血液服务数据库和澳大利亚和新西兰活体肾脏捐献者登记处（ANZLKD）中捕获的发病患者研究人群，以及他们的相关健康数据。健康数据源将包括国家非入院患者收集数据、国家最小数据集、癌症登记处、精神健康数据整合计划（PRIMHD）、药品报销数据库和死亡率收集数据库。初步示例研究包括：1）肾脏候补名单动态和移植途径；2）精神疾病对进入肾脏候补名单和移植的影响；3）活体捐献者捐赠后的卫生服务使用情况。
ASSET 链接数据平台将为基于人群的卫生服务研究提供机会，以检查新西兰卫生保健提供的公平性和健康结果。它还提供了潜力，通过确定当前卫生系统中可以改进的地方，为新西兰的人提供公平获得卫生服务的机会，为未来的服务规划提供信息。
