Improving access to housing for Aboriginal and Torres Strait Islander renal patients with complex care needs

Abstract

Aboriginal and Torres Strait Islander renal patients experience multiple layers of disadvantage, partly as a consequence of the ways in which government services are provided. In remote Northern Territory communities, rates of end stage kidney disease (ESKD) are 15or more times higher amongst Aboriginal and Torres Strait IslanderAustralians, in comparison to non-Indigenous Australians of the same age and sex,and are rapidly increasing.Current models of care for ESKD resultin approximately 80% of all patients undertaking dialysis being required to permanently relocatefrom remote communitiesto urbanareas for treatment. While access to remoterenalservices is improvingthrough recent initiatives including a new Medicare item for remote dialysis, several logistical and medical barriers will continue to prevent many patients with complex care needs from accessing remote services.Patients with complex care needs require access to affordable, accessible and culturally safe housing and accommodation. This Issues Briefsynthesises the evidence regarding the impairments sustained by Aboriginal and Torres Strait Islander renal patients, and how impairments may impact on housing needs. It shows that while the experience of ESKD will vary from person to person, patients are likely to be living with impairmentsthat may be unrecognised, undiagnosed and unsupported.It highlights the important role of carers and the need for housing and accommodation thatreflects Aboriginal and Torres Strait Islander people’s practices of care. This Issues Briefinvestigates access to housing and accommodation amongstAboriginal and Torres Strait Islander renal patients who relocate for treatment. It finds that a lack of appropriate, accessible and affordable housing,poorly targeted housing strategies,and delays in income support paymentscan result in housing exclusion and risk of homelessness amongst patients.Failure to address the housing and accommodation of renal patients can also lead toinefficiencies and wastage in health services.Holistic, integrated and collaborativeapproaches are recommendedto meet the complex careneeds of Aboriginal and Torres Strait Islander renal patients who relocate permanentlyto urban centres for treatment, as well as the needsof their carers.An integrated care package schemeis proposed to addressthe housing and support needs and preferences of each patient and their family, with an emphasis on providing choice. Show more