An observational study of the quality of care for chronic kidney disease: a Buffalo and Albany, New York metropolitan area study
| Autor: | Rocco C. Venuto, J. James Bono, Laura Argauer, Pradeep Arora, Peter L. Elkin, Raghu Ram, Brian M. Murray, Joseph Eberle |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Referral Cross-sectional study medicine.medical_treatment Population New York Inappropriate Prescribing urologic and male genital diseases Medication prescription Claims data mining Cost of Illness Chronic kidney disease Internal medicine Prevalence medicine Humans Renal Insufficiency Chronic Medical prescription education Referral and Consultation Dialysis Aged Quality of Health Care Retrospective Studies education.field_of_study Clinical Laboratory Techniques business.industry Health Care Costs Quality of care assessment Middle Aged medicine.disease Cross-Sectional Studies Female business Research Article Kidney disease |
| Zdroj: | BMC Nephrology |
| ISSN: | 1471-2369 |
| Popis: | Background The database of a major regional health insurer was employed to identify the number and frequency of covered patients with chronic kidney disease (CKD). We then examined the characteristics of their care as defined, in part, by the frequency of physician visits and specialty referral, the characteristics of laboratory testing and total costs as indices of the quality of care of the subject population. Methods This retrospective, cross-sectional study analyzed insurance claims, laboratory results and medication prescription data. Patients with two estimated glomerular filtration rate readings below 60 ml/min/1.73 m2 (n = 20,388) were identified and classified by CKD stage. Results The prevalence of CKD stages 3a and above was 12 %. Vascular comorbidities were common with prevalence increasing steadily from stage 3a through stage 5. Only 55.6 % of stage 4 CKD patients had claims for nephrology visits within one year of their index date. Fifty-nine percent of patients had claims for renin-angiotensin system (RAS) blockers. Twenty-five percent of patients in stage 3a CKD filled a prescription for non-steroidal anti-inflammatory drugs. Fifty-two percent of patients who developed end-stage renal disease received their first dialysis treatment as inpatients. Conclusions The pattern of medical practice observed highlights apparent deficiencies in the care of CKD patients including inappropriate medication use, delayed nephrology referral, and a lack of preparation for dialysis. This study shows the potential value of using large patient databases available through insurers to assess and likely improve regional CKD care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink