在退伍军人卫生管理局获得腹膜透析的障碍和机会
Anuradha Wadhwa1,2, Scott Reule3,4, Kerri L Cavanaugh5,6
1Edward Hines Jr. VA Hospital, Hines, Illinois.
Clinical journal of the American Society of Nephrology : CJASN
|September 15, 2025
概括
腹腔透析 (PD) 在美国退伍军人中使用率很低. 一项调查发现,许多VHA中心希望提供PD,但面临成本和人员等障碍. 需要支持,以增加退伍军人的PD访问.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗保健管理部门的管理.
- 公共卫生 公共卫生
背景情况:
- 腹腔透析 (PD) 的利用率在美国退伍军人中明显低于患有功能衰竭的非退伍军人.
- 加强退伍军人卫生管理局 (VHA) 内的PD访问对于实现国家健康目标至关重要.
研究的目的:
- 评估退伍军人在整个VHA获得PD的机会.
- 确定扩大VHA附属PD服务的障碍和机会.
主要方法:
- 一项全国范围的电子调查被分发给VHA内的脏病利益相关者.
- 在141个符合条件的中心中,有117个 (83%) 响应,其中包括97个提供科服务的设施.
主要成果:
- 理想情况下,PD可以为25%的患有功能衰竭的退伍军人提供服务,但只有28%的中心提供门诊PD服务 (中位数为10名退伍军人).
- 30%的不提供PD的中心表示有兴趣建立服务,积极与功能衰竭前教育和住院PD计划相关联.
- 主要障碍包括系统挑战 (空间,成本) 和人员短缺 (护士,辅助人员).
结论:
- 退伍军人对基于VHA的PD计划的有限访问是PD利用的一个未被认可的障碍.
- VHA脏病学利益相关者希望扩大PD服务,但需要当地和系统层面的支持.
- 正式的VHA政策,行政指导和护士培训是克服PD使用不足的关键策略.
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