The provision of renal replacement therapy for adults in England and Wales: recent trends and future directions
| Autor: | G Ferris, Paul Roderick, T G Feest |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_specialty Evidence-based practice Adolescent Cost effectiveness medicine.medical_treatment Population Age Distribution Surveys and Questionnaires medicine Humans Renal replacement therapy Sex Distribution education Aged Aged 80 and over Health Services Needs and Demand education.field_of_study Wales business.industry Patient Selection General Medicine Middle Aged medicine.disease Comorbidity Surgery Renal Replacement Therapy Transplantation Hemodialysis Units Hospital England Health Care Surveys Utilization Review Kidney Failure Chronic Hemodialysis business Kidney disease Demography |
| Zdroj: | QJM. 91:581-587 |
| ISSN: | 1460-2393 |
| DOI: | 10.1093/qjmed/91.8.581 |
| Popis: | We assessed the level of provision of renal replacement therapy for adults in England and Wales. All autonomous main renal units in England (n = 52) and Wales (n = 5) were surveyed in 1996. Data for England were compared to the 1993 National Renal Review. The acceptance rate in England 1995 was 82 (80-85) per million population (p.m.p.) compared with 67 (65-70) p.m.p. in 1991-2. The rate in 1995 in Wales was 109 (98-122) p.m.p. The prevalence rate in England was 476 p.m.p. at end-1995 compared to 393 p.m.p. in 1993, in Wales it was 487 p.m.p. The number of main renal units in England did not rise between 1993 and 1995; capacity was increased by use of more treatment shifts and temporary haemodialysis stations, and by opening more satellite units. The main growth was in hospital haemodialysis. There was an uneven geographical distribution of services. Patients accepted were older with more comorbidity. The use of better-quality processes of dialysis increased. The steady-state position for RRT will not be reached for over a decade. Health authorities will face continued pressure to fund increases in quantity and quality improvements. A stronger evidence base of the effectiveness of therapies, and a national registry to monitor the equity and cost-effectiveness of services are needed. |
| Databáze: | OpenAIRE |
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