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Does Selection and Management of Patients with Chronic Kidney Disease In Government Run and Private Hospitals Differ?
Anoop Gowda1, Aswini Raghavendra Dutt2, Shobith Bangera3
1Assistant Professor, Division of Nephrology, Department of Medicine, Ambedkar Medical College, Bengaluru, Karnataka, India.
Insights
Chronic kidney disease (CKD) patients in India show varied management and disease patterns between government and private hospitals. While access failure rates were similar, private facilities offered more frequent dialysis and specialist follow-ups.
Area of Science:
- Nephrology
- Public Health
- Healthcare Management
Background:
- Rising global incidence of Chronic Kidney Disease (CKD) necessitates effective patient management.
- Haemodialysis is crucial for improving quality of life in CKD patients.
- Healthcare delivery for CKD varies between government and private sectors, impacting patient outcomes.
Purpose of the Study:
- To compare the selection, management, and disease patterns of CKD patients undergoing dialysis in government versus private hospitals.
- To identify differences in comorbidity, dialysis frequency, and access failure rates.
- To analyze patient follow-up and treatment protocols across different healthcare settings.
Main Methods:
- A cross-sectional study involving 129 patients in a government hospital and 182 in a private hospital in Karnataka, India.
- Comparison of parameters including comorbidity (diabetes), dialysis frequency, access failures, and follow-up visits.
- Statistical analysis using the Chi-squared test with significance set at p < 0.05.
Main Results:
- Government hospitals treated younger CKD patients with higher comorbidity rates (p<0.001).
- Private hospital patients received more frequent dialysis, specialist nephrologist follow-ups, and erythropoietin (p<0.001).
- No significant difference in access failure rates was observed between the two hospital types.
Conclusions:
- CKD patient management showed no inherent bias between government and private hospitals.
- Variations in available facilities and treatment intensity exist between public and private healthcare sectors for CKD patients.
- Further research into facility-specific impacts on CKD progression and outcomes is warranted.
Introduction:
Globally, incidence of Chronic Kidney Disease (CKD) is rapidly rising with huge burden on the life expectancy of the patients. Regular haemodialysis improves the quality of life in these patients. They get treatment at either government run or private sector hospitals. A difference in disease pattern, comorbidity, patient management and number of access failures can be observed in these set ups.
Aim:
The present study was carried out to find out selection, management and disease pattern of CKD patients admitted for dialysis in government run and private hospital.
Materials And Methods:
A cross-sectional study on patients (18-90 years) admitted and undergoing dialysis at government run (N=129) and private hospital (N=182) was undertaken in Karnataka, India. Parameters like comorbidity (diabetes), number of dialysis per week, number of access failures, and follow up visits were compared between these patients. Chi- squared test was used to compare the data. All tests were two-tailed and p< 0.05 was considered as significant.
Results:
More number of younger patients and associated comorbidity, were seen in patients admitted in government run hospital (p<0.001), with no gender bias in selection of patients for dialysis between the two hospitals. Similarly, follow-ups with nephrologist, number of dialysis done per week and erythropoietin supplements administered were significantly more among private hospital patients (p<0.001). Number of dialysis sessions and mean haemoglobin level was less in government run hospital patients, as compared to those in private hospital. No statistical difference was seen with access failure in both these setups.
Conclusion:
No bias in management of CKD patient was seen among the two sets of hospitals though available facilities seemed to vary.
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