A look at dialysis delivery in Australia

Australia, in a sense, has as many dialysis delivery systems as it has states, with the differences in delivery systems being far greater between those states than is the case, for example, in the U.S. However, if common trends are apparent across the nation in dialysis delivery, they include: an increasing tendency to move HD delivery out of major teaching hospital centres into the community a modest decrease in PD use as more HD becomes available an increased role for the private sector in terms of HD delivery, ranging from direct facility ownership to pay-per-treatment arrangements in public hospitals an awareness of a need to make particular provision for the Aboriginal population, given their high rate of ESRD, their geographical dispersion, and their socio-economic deprivation. It will be interesting to observe how these processes evolve in the years ahead and whether these initiatives lead to "catch up" in Australia's incidence of treated ESRD relative to that of other Western countries.