Use of National Registry Demographic Data for Resource Planning

Introduction

Australia’s combination of a large land area (7.7 million square km) and relatively small population (22.7 million) contributes to unique resource planning issues for specialist services. The population density of Australia is 2.9 people per square km, compared with 32.7 in the USA, 256.3 in the United Kingdom and 337.4 in Japan. Despite high urbanisation in Australia, many patients need to travel long distances for treatment, particularly those receiving allogeneic transplants. In 2011, 498 allogeneic transplants were performed in Australia. With increasing post transplant survival and recognition of the long term follow-up needs of survivors, it is important to optimise the use of resources so that all patients have access to appropriate care.

Methods

Residential postcodes were available for 3,655 of the 4041 patients who received allogeneic transplants in Australia from 2002-2011 (90%). These postcodes were extracted from the ABMTRR database and converted via geocoding into latitude and longitude for display onto a map. This same method was used to obtain a location for the transplant centres. Distances from the residential postcodes to the transplant centres were calculated and analysed.

Results

The median distance travelled for allogeneic transplant patients in Australia was 25.7 km (range 0.1 km - 3,155 km). Thirty nine percent of patients travelled more than 50 km to their transplant centre, with 28% travelling more than 100 km and 6% travelling more than 500 km. On average, patients travelled longer distances to paediatric centres than adult centres.

Conclusions

Visualisation of referral patterns on maps and analysis of the distances between residential addresses and transplant centres are useful tools for developing follow-up protocols. It is anticipated that e-health services will become an important aspect of the long term care of transplant patients, and will be especially beneficial for patients in remote areas.