Authors: Winnie Chen1,2,Kirsten Howard2, Gillian Gorham1, Asanga Abeyaratne1,3, Yuejen Zhao4, Oyelola Adegboye1, Nadarajah Kangaharan5, Sean Taylor1,4, Louise J. Maple-Brown1,6, Samuel Heard7, Mohammad Radwanur Talukder1, Abdolvahab Baghbanian7, Sandawana William Majoni3 and Alan Cass1 on behalf of Territory Kidney Care Steering Committee8
Affiliations:
1 Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
2 Leeder Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
3 Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
4 Northern Territory Health, Darwin, Northern Territory, Australia
5 Division of Medicine, Northern Territory Health, Darwin, Northern Territory, Australia
6 Division of Endocrinology, Northern Territory Health, Darwin, Northern Territory, Australia
7 Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
8 Members of the Territory Kidney Care Steering Committee are listed in the Appendix of the published paper
The following is a summary of a research paper by the authors. For more information, please see the published full-text journal article: https://www.kireports.org/article/S2468-0249(24)01996-X/fulltext
Chronic kidney disease in the NT
Chronic kidney disease is a major health issue in the Northern Territory (NT), particularly amongst First Nations Australians living in remote areas. In remote NT communities there are high levels of undiagnosed chronic kidney disease with limited access to optimal care. This leads to early kidney failure requiring dialysis or kidney transplant. These treatments come with a heavy personal burden to patients and a high cost to the health system.
The Territory Kidney Care tool
Territory Kidney Care is a digital health tool designed to improve early detection and management of chronic kidney disease. The tool was developed and implemented in partnership with NT government health services and Aboriginal community controlled health organisations. We evaluated the cost-effectiveness of this tool using a new chronic kidney disease model. The model tracks disease progression over 15 years, and is based on real-world data from over 23,000 people living in remote NT – most of whom are First Nations Australians.
We considered several scenarios in the cost-effectiveness analysis. We analysed cost-effectiveness of the Territory Kidney Care tool in improving chronic kidney disease diagnosis, improving management, or improving both diagnosis and management. Our results showed that even a modest improvement in both diagnosis and management would be considered highly cost-effective. The incremental cost-effectiveness ratio in this scenario would be $3,427 per quality-adjusted life year (QALY) gained.
Policy implications
Digital health tools like Territory Kidney Care offer a cost-effective opportunity to improve kidney outcomes for people in the NT. By supporting earlier diagnosis and better clinical management, such tools can reduce long-term health system costs and contribute to more equitable health outcomes in the NT.
Source: Visual abstract
