在格鲁吉亚的末期脏病患者中,透设施转移脏移植的变化
Rachel E Patzer1, Laura C Plantinga2, Sudeshna Paul3
1Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia2Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia3Emory Transplant Center, Atlanta, Georgia.
JAMA
|August 12, 2015
概括
在格鲁吉亚,只有24.4%的透析患者被转诊接受移植评估. 透析设施之间的转诊率有很大差异,患者的社会经济地位和设施类型等因素影响了差异.
科学领域:
- 肝脏病学
- 移植医学
- 公共卫生
背景情况:
- 透析设施必须向末期病患者提供包括移植在内的所有治疗方案.
- 透析机构的转诊是患者开始移植评估过程的关键步骤.
- 透析患者转移移植的比例在很大程度上是未知的.
研究的目的:
- 调查透析设施层面的移植评估转诊率的变化.
- 在格鲁吉亚的透析患者中确定与移植转诊有关的因素.
- 了解移植率最低的州的差异.
主要方法:
- 在308个格鲁吉亚医院 (2005-2011) 开始透析的15279名ESRD患者的数据分析.
- 将美国脏数据系统数据与格鲁吉亚移植中心的脏转移数据联系起来.
- 主要结局:在开始透析后1年内转诊进行移植评估.
主要成果:
- 转诊率的中位数为24. 4%,设施差异从0%到75. 0%.
- 转诊率较低的医院在贫困地区服务的患者数量更高, 患者与社会工作者比例也更高.
- 非营利机构的地位与更低的转诊率有关,但转诊和等待列表的因素并不总是一致的.
结论:
- 格鲁吉亚少数透析患者被转诊接受移植评估 (2005 - 2011年),这突显了医疗护理方面的重大差距.
- 透析机构之间的转诊实践存在很大差异.
- 转诊的差异可能与影响等待名单的因素不同,表明需要有针对性的干预措施.
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