在报告估计的膜过率之前和之后, nefrology 访问和医疗保健资源使用
Brenda R Hemmelgarn1, Jianguo Zhang, Braden J Manns
1Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Brenda.Hemmelgarn@albertahealthservices.ca
JAMA
|March 25, 2010
概括
实验室报告估计的膜过率 (eGFR) 增加了慢性病 (CKD) 患者的科医生访问. 这种趋势在严重功能障碍,女性和老年人中最为明显. 需要进一步的研究来确定对患者结果的影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 实验室报告估计的膜过率 (eGFR) 是常见的,但被低估.
- 了解eGFR报告对医疗保健利用的影响对于患者管理至关重要.
研究的目的:
- 在eGFR报告实施后,调查科医生访问和医疗保健资源使用的变化.
- 分析与eGFR报告相关的患者管理和专家转诊趋势.
主要方法:
- 一项基于社区的队列研究,涉及加拿大阿尔伯塔省的1,135,968名参与者.
- 时间序列分析用于比较eGFR报告实施 (2004年10月15日) 之前和之后的趋势.
- 数据收集时间为2003年5月15日至2007年3月14日.
主要成果:
- 报告eGFR与慢性病 (CKD) 患者科医生访问的显著增加相关.
- 对于EGFR<30mL/min/1.73m的患者,女性,以及患有高血压和糖尿病等并发症的患者来说,访问的增加尤其显著.
- 没有发现eGFR报告与全科医生或内科医生的访问,也没有发现CKD患者使用特定药物的联系.
结论:
- 报告eGFR与对科医生的转诊增加有关,特别是对于晚期病患者.
- 特定的人口和临床因素会影响转诊后EGFR报告的可能性.
- 与这些增加的科医生访问相关的长期临床结果需要进一步调查.
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