Effects of Higher Quality of Care on Initiation of Long-term Dialysis in Patients With CKD and Diabetes

Wu, Hon Yen; Fukuma, Shingo; Shimizu, Sayaka; Norton, Edward C.; Tu, Yu–Kang; Hung, Kuan‐Yu; Chen, Mei‐Ru; Chien, Kuo–Liong; Fukuhara, Shunichi

doi:10.1053/j.ajkd.2017.05.020

Cited by 15 publications

(9 citation statements)

References 31 publications

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“…The present study suggests that survival differences between SES groups are therefore unlikely due to differences in QOC that are routinely measured on dialysis. Other plausible factors that may have a role include (i) patient‐related: health associated literacy and behaviours, cultural beliefs, co‐morbidities (beyond those collected in ANZDATA), frailty; (ii) environment‐related: rurality and remoteness from health care; (iii) health‐care system‐related: chronic kidney disease awareness programs and prevention measures, pre‐dialysis care, private versus public nephrology care . National registries and future clinical studies should consider inclusion of patient‐related outcome measures as QOC indicators.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status and dialysis quality of care

et al. 2019

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Aim Lower socioeconomic status (SES) has been associated with increased dialysis mortality. This study aimed to determine if the quality of care (QOC) delivered to dialysis patients varied by SES. Methods All non‐Indigenous adults commencing haemodialysis (HD) or peritoneal dialysis (PD) registered with the Australia and New Zealand Dialysis and Transplant Registry between 2002 and 2012 were included. Each patient's location at dialysis start was classified into SES quartiles of advantaged to disadvantaged. Guidelines were used to determine attainment of adequate QOC at 6–<18 months and 18–<30 months after dialysis start, using logistic regression models. QOC measures included pre‐dialysis phosphate, calcium, haemoglobin, transferrin saturation and ferritin. HD‐related parameters included single pool Kt/V and percentage with functioning arteriovenous fistula/graft. PD‐related parameters included weekly Kt/V and percentage transferring to HD. Results Of 19 486 commencing dialysis, the median age was 65 years (interquartile range 53–74), 62.2% were male and 85.1% were Caucasian. At 6–<18 months after dialysis start, there were no significant differences by SES in attainment of biochemical targets, PD or HD adequacy. The disadvantaged quartile was less likely to achieve haemoglobin targets (odds ratio 0.88, 0.80–0.96, P = 0.01) or have a functioning arteriovenous fistula or graft (odds ratio 0.79, 0.68–0.92, P = 0.003) compared with the most advantaged group. Vascular access differences persisted at 18–<30 months. Conclusion Other than vascular access, area‐level SES has minimal impact on QOC attainment among non‐Indigenous dialysis patients in Australia. Increased mortality in lower SES groups may be due to pre‐dialysis factors and other variables such as health‐related behaviours, lifestyle and literacy.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic status and dialysis quality of care

et al. 2019

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“…However, we detected similar associations between the QS and ESRD among diabetes patients in Taiwan. 19 Fourth, death during the follow-up period was treated as a target for censorship in this study; death can be a competing risk for ESRD. Although the mortality rate was expected to increase with age, we found consistent results among age groups (Supplemental Digital Content 6, Table 5, http://links.lww.com/MLR/ B963).…”

Section: Discussionmentioning

confidence: 99%

“…We previously developed a set of 11 QIs for CKD patients using the Delphi method (modified RAND appropriateness method) 16 and validated these indicators using a claims database in Taiwan. 19 Herein, we selected 3 QIs: urine test, nutritional guidance, and nonsteroidal anti-inflammatory drugs (NSAIDs) avoidance identifiable by procedure codes in the claims data. NSAIDs avoidance was defined as evidence of prescription of NSAIDs for <14 days/mo.…”

Section: Definition Of Quality Score and Covariatesmentioning

confidence: 99%

Quality of Care in Chronic Kidney Disease and Incidence of End-stage Renal Disease in Older Patients

et al. 2020

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; † ‡ ‡ and on behalf of BiDANE: Big Data Analysis of Medical Care for the Older in Kyoto Background: The quality of care received by a growing number of older patients with chronic kidney disease (CKD) has not been adequately examined. Objective: The objective of this study was to assess the quality of CKD care among older patients and to clarify its association with the incidence of end-stage renal disease (ESRD).

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“…ESRD is associated with increased mortality and cardiovascular events. 1 In ESRD patients, optimization of quality of care is consequently a major issue, and monitoring of specific indicators is therefore mandatory.…”

Section: Introductionmentioning

confidence: 99%

Improving Quality of Care in Hemodialysis: a Content Analysis

Hashemi¹,

Irajpour²,

Abazari³

2018

J Caring Sci

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Introduction: Hemodialysis is currently the most common alternative treatment in patients with renal failure in the world. Today, despite the support provided by healthcare providers for these patients, they still express dissatisfaction with the quality of care and find it inadequate. However, there have been few studies investigating the needs of in-patients receiving hemodialysis care in Iran. Thus this research was undertaken to study the needs and demands of such patients. Methods: This qualitative research was conducted from June to November 2016 to investigate the view points of the patients, their families and health care providers about improving quality of care in dialysis unit. At first, the sampling was based on a purposeful sampling method. A total of 35 participants (patients, their families and health care providers) were interviewed. The interviews were analyzed via Graneheim & Lundman qualitative content analysis. Results: Data analyses led to the production of 700 primary codes, 54 subcategories and 27 secondary categories out which 4 main categories of modification of physical stressors, requirement of support and the requirement of improved quality of Health Care service and improved facilities and equipment requirement. Conclusion: Planning for modification of physical stressors, improved support of patients, enhancing the quality of care services provided by the treatment team, upgrading the facilities and equipment and the adoption of an interdisciplinary approach are all believed to improve the care services among in-patients receiving hemodialysis treatment.

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Effects of Higher Quality of Care on Initiation of Long-term Dialysis in Patients With CKD and Diabetes

Abstract: Our findings suggest potential opportunities to improve long-term outcomes among patients with diabetes and CKD by improving the quality of their CKD care.

Cited by 15 publications

References 31 publications

Socioeconomic status and dialysis quality of care

Socioeconomic status and dialysis quality of care

Quality of Care in Chronic Kidney Disease and Incidence of End-stage Renal Disease in Older Patients

Improving Quality of Care in Hemodialysis: a Content Analysis

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