Quintaliani Giuseppe, Postorino Maurizio, Di Napoli Anteo, Limido Aurelio, Dal Canton Antonio, Balducci Alessandro, Contu Bruno, Salomone Mario, Nordio Maurizio, Levialdi Ghiron Jung Hee, Viglino Giusto, Pizzarelli Francesco, Coppo Rosanna
Coordinatore Governo Clinico SIN, Italy.
G Ital Nefrol. 2012 Jan-Feb;29(1):70-80.
This paper reports the analysis of the second part of the data obtained from the second SIN census and illustrates the management model of the Italian dialysis centers, highlighting its strengths but also its limits. The census was carried out between March and December 2008 with a webbased survey using fillable PDF forms. The survey was validated by comparing the data with those sent to the Italian Dialysis and Transplant Register (Registro Italiano di Dialisi e Trapianti, RIDT) and hence it refers to December 31, 2008, the date of the last RIDT report. Forty-two percent of dialysis centers, which altogether take care of 50% of Italian dialysis patients, participated in the census. The participation percentage was very variable among Italian regions (from 5% to 100% of dialysis centers). By excluding the three regions with a participation rate below 10%, the survey reached a participation rate of 68% of all Italian dialysis centers and is therefore sufficient to give an estimate of the Italian dialysis situation. However, because of this variability it was not possible to compare regional situations, and the data were evaluated only by analyzing the ''complex'' and ''simple'' dialysis centers separately. The state of affairs of dialysis in Italy on the whole proved to be complicated. It is striking, for example, that 15% of the ''complex'' dialysis centers do not have their own hospital beds and some of them lack traceability programs. Noteworthy are also the increasing use of central venous catheters and the number of patients that need an ambulance to get to the dialysis center. Despite its limits due to the reduced participation in the census, this work offers a fair description of the state of affairs of dialysis in Italy, where there is certainly space for qualitative improvement. First of all, however, every effort should be made to implement and improve the use of the existing structures and to standardize protocols and behaviors in all Italian dialysis centers.
本文报告了对第二次意大利肾脏病登记处（SIN）普查所获数据第二部分的分析，并阐述了意大利透析中心的管理模式，突出了其优势及局限性。此次普查于2008年3月至12月进行，采用基于网络的可填写PDF表格进行调查。通过将数据与发送至意大利透析与移植登记处（Registro Italiano di Dialisi e Trapianti, RIDT）的数据进行比较，该调查得到了验证，因此其数据截止至2008年12月31日，即RIDT最后一份报告的日期。42%的透析中心参与了此次普查，这些中心共照料着50%的意大利透析患者。意大利各地区的参与率差异很大（从透析中心的5%至100%）。排除参与率低于10%的三个地区后，该调查的参与率达到了意大利所有透析中心的68%，因此足以对意大利的透析情况做出估计。然而，由于存在这种差异，无法对各地区情况进行比较，数据仅通过分别分析“综合”和“简易”透析中心来评估。意大利整体的透析状况被证明是复杂的。例如，令人惊讶的是，15%的“综合”透析中心没有自己的病床，其中一些还缺乏可追溯程序。同样值得注意的是中心静脉导管的使用日益增加，以及需要救护车送往透析中心的患者数量。尽管由于普查参与率降低存在局限性，但这项工作对意大利的透析状况进行了较为合理的描述，在意大利，质量改进肯定还有空间。然而，首先应尽一切努力实施并改进现有设施的使用，并使意大利所有透析中心的协议和行为标准化。
