在维持透析开始之前的患者护理缺口:基于人口的回顾性研究
Amber O Molnar1,2,3,4, Danielle M Nash3,5, Jennifer Emblem6
1Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Canadian journal of kidney health and disease
|November 29, 2023
概括
许多患者在开始透析前错过了推的多学科关护理. 这项研究突出了慢性病 (CKD) 查和科转诊方面的差距,表明错过了及时护理的机会.
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:
- 加拿大安大略省的指导方针建议在计划开始透析时及时提供多学科的脏护理.
- 存在很大的差距,许多患者没有接受推的透析前护理.
研究的目的:
- 研究患者启动维持透析的途径.
- 了解透析前多学科关怀缺口背后的原因.
主要方法:
- 在加拿大安大略省使用基于人口的医疗保健行政数据库进行了回顾性队列研究.
- 包括在2016年4月至2019年3月期间开始维持透析的成年人.
- 根据接受推的多学科脏护理 (≥1年,≥2次访问) 并确定特定的护理缺口 (CKD查,科转诊时间) 来分类患者.
主要成果:
- 在9216名患者中,59%的患者没有接受推的多学科脏护理.
- 在没有推护理的患者中,41.4%没有发现缺口,24.9%缺乏及时的CKD查,6.6%迟迟转诊病学,而27.1%的患者尽管经过了病学随访,却迟迟或根本没有转诊多学科护理.
- 患者的结局包括死亡 (9.7%),继续接受透析 (83.2%),或在90天内恢复功能 (7.0%).
结论:
- 在安大略省,超过一半开始透析的患者没有接受推的多学科脏护理.
- 确定的错失机会包括不充分的慢性病查和延迟转诊科或多学科护理.
- 调查结果可以为政策制定提供信息,以改善透析前护理的使用率和患者的治疗结果.
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