{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:33:53Z","timestamp":1791657233902,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The Australian and New Zealand Society of Nephrology (ANZSN) established a quality indicator (QI) program to measure performance and reduce variation of nephrology care. This program relies on registry data from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). ANZDATA also conducts surveys to ascertain more granular characteristics of participating nephrology units to better understand variation in practice. This study assessed ANZDATA and nephrology unit surveys to determine patient\u2010 and centre\u2010level factors that may account for variation in dialysis access QIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dialysis access QIs were evaluated over a 5\u2010year period using ANZDATA (2016\u20132020). Patient characteristics were derived from the same period and dataset. Centre characteristics were determined from the 2020\u2010unit binational survey. Statistical analysis involved multivariable regression with fixed effects for patient\u2010 and centre\u2010characteristics and a random effect by centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Wide variation was seen across dialysis access QIs. Using multivariable regression, patient\u2010level characteristics associated with definitive dialysis access at commencement of dialysis included male gender and body mass index decreasing from 30\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Centres with a home haemodialysis nurse and a \u2018peritoneal dialysis (PD) first policy\u2019 were associated with higher rates of definitive dialysis access. There was also a progressive relationship with the number of full\u2010time equivalent (FTE) medical staff if the unit already had an FTE greater than 10. Inclusion of centre\u2010level variables reduced the variance in the model by 68%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates certain patient\u2010 and centre\u2010level characteristics are associated with definitive dialysis access at the commencement of dialysis in Australia and New Zealand. Interventional trials for PD first programmes and different models of care for vascular access are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70076","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T02:09:50Z","timestamp":1753322990000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Variability in Dialysis Access Over Time and Across Centres in Australia and New Zealand: Effect of Centre\u2010 and Patient\u2010Related Factors on Dialysis Access Quality Indicators"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5218-0424","authenticated-orcid":false,"given":"Adam G.","family":"Steinberg","sequence":"first","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Parkville Australia"},{"name":"Department of Medicine (RMH) University of Melbourne  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2853-5096","authenticated-orcid":false,"given":"Nigel D.","family":"Toussaint","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Parkville Australia"},{"name":"Department of Medicine (RMH) University of Melbourne  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6595-8656","authenticated-orcid":false,"given":"Christopher E.","family":"Davies","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences University of Adelaide  Adelaide Australia"},{"name":"Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI)  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A.","family":"Gray","sequence":"additional","affiliation":[{"name":"Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI)  Adelaide Australia"},{"name":"Department of Nephrology Sunshine Coast University Hospital  Birtinya Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences University of Adelaide  Adelaide Australia"},{"name":"Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI)  Adelaide Australia"},{"name":"Central and Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070643"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1607-551X(09)70544-3"},{"key":"e_1_2_9_4_1","unstructured":"https:\/\/www.anzdata.org.au\/report\/anzdata\u201046th\u2010annual\u2010report\u20102023\u2010data\u2010to\u20102022\/."},{"key":"e_1_2_9_5_1","unstructured":"https:\/\/www.anzdata.org.au\/anzdata\/services\/data\u2010management\/data\u2010collection\/."},{"key":"e_1_2_9_6_1","unstructured":"Australian Bureau of Statistics \u201cSocio\u2010Economic Indexes for Areas (SEIFA): Technical Paper \u201d ABS 2021 https:\/\/www.abs.gov.au\/statistics\/detailed\u2010methodology\u2010information\/concepts\u2010sources\u2010methods\/socio\u2010economic\u2010indexes\u2010areas\u2010seifa\u2010technical\u2010paper\/2021."},{"key":"e_1_2_9_7_1","unstructured":"Australian Bureau of Statistics \u201cAustralian Statistical Geography Standard (ASGS) Edition 3 \u201d ABS Jul 2021\u2013Jun 2026 https:\/\/www.abs.gov.au\/statistics\/standards\/australian\u2010statistical\u2010geography\u2010standard\u2010asgs\u2010edition\u20103\/jul2021\u2010jun2026."},{"key":"e_1_2_9_8_1","volume-title":"ANZDATA Special Reports 1: Unit Survey 2020","author":"McDonald S.","year":"2021"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajkd.2003.07.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12798"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-018-0737-9"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000566"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.06.026"},{"issue":"8","key":"e_1_2_9_14_1","first-page":"S19","article-title":"Towards Equity in Kidney Transplantation: The Next Steps","volume":"219","author":"Hughes J. 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