- To examine the relationship between the pooled Indigenous & non-Indigenous index of Relative Socioeconomic Outcomes (PINIRSEO) and the Indigenous and non-Indigenous incidence of renal replacement therapy, taking age and sex differences into account.
- To examine the relationship between PINIRSEO and the Indigenous and non-Indigenous outcomes of dialysis (namely, death or transplantation as “competing risks”), taking demographic, comorbidity and remoteness differences into account.
- To examine the relationship between PINIRSEO and the Indigenous and non-Indigenous outcomes of transplantation (namely, death or return to dialysis treatment as “competing risks”), taking demographic, comorbidity, immunological and remoteness differences into account.
Outcomes of RRT are also worse for Indigenous Australians, once demographic, comorbidity and residential remoteness are accounted for. They are much less likely to get a kidney transplant. Kidney disease is a major burden during life for Indigenous Australians and their communities, and also accounts for 15.8% of Indigenous deaths between 2008 and 2012 (using underlying or associated causes), contributing 5% of the total disparity between Indigenous and non-Indigenous mortality (using underlying causes only).
The use of area-level socioeconomic status measurements using ABS Socio-Economic Indices For Areas (SEIFA), particularly the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD), is well-established in the Australian health epidemiology literature.
However, the publicly available indices are of limited use for comparisons among Indigenous groups or between Indigenous and non-Indigenous groups due to ecological bias and the fact that they do not discriminate between Indigenous groups. An alternative has been proposed to deal with these issues: the Index of Relative Socio-Economic Outcomes (IRSEO) and related indices (PNIRSEO & PINIRSEO).
To our knowledge it has not been applied to Indigenous or non-Indigenous health outcomes data before.