Servicio de Nefrología, Hospital Reina Sofía de Tudela, Tudela, Navarra, Spain.
Nefrologia. 2012;32(5):659-63. doi: 10.3265/Nefrologia.pre2012.Jun.11426.
At present, there is no adequate system available for evaluating dialysis centres.
To construct an overall haemodialysis results weighting system, acceptable to the different stakeholders involved which allows the comparison of centres using a compound marker.
The Quality Management Work Group of the Spanish Society of Nephrology (WG) established a set of preselected indicators. A Focus Group, independent of the WG, was established. It was made up of nine individuals: three patients, three clinicians and three clinical managers, who assessed these indicators using an approved methodology and established the selected indicators. Finally, the indicators were weighted through three weighting stages, each separated by two debate periods, which involved the distribution of 100 points between each variable, according to the personal assessment and the debate sustained.
The clinical results included: haemodialysis doses, anaemia, plasma calcium and phosphorus, type of vascular access, and hospitalisation days. The weighting given to each variable following the third weighting process, expressed as an average of all the factors, was as follows: clinical results 38.9; annual mortality 25.0; satisfaction with the centre 12.2; health-related quality of life 15.6; and cost 8.3 (total 100).
The weighting structure covers relevant and overall results and includes the opinion of all stakeholders involved; all of which will increase its acceptability and widespread use and contribute to the analysis of the value produced by the centres and the improvement of the results.
目前，尚无评估透析中心的充分系统。
构建一个整体血液透析结果加权系统，让不同利益相关者接受，使用复合指标比较中心。
西班牙肾脏病学会（WG）质量管理工作组确定了一组预选指标。成立了一个独立于 WG 的焦点小组，由九名成员组成：三名患者、三名临床医生和三名临床经理，他们使用经过批准的方法评估这些指标，并确定选定的指标。最后，通过三个加权阶段对指标进行加权，每个阶段之间有两个辩论期，根据个人评估和辩论，在每个变量之间分配 100 分。
临床结果包括：血液透析剂量、贫血、血浆钙和磷、血管通路类型和住院天数。经过第三次加权处理后，每个变量的加权平均值如下：临床结果 38.9；年死亡率 25.0；对中心的满意度 12.2；健康相关生活质量 15.6；成本 8.3（总计 100）。
加权结构涵盖了相关和整体结果，并包含了所有利益相关者的意见；这将提高其可接受性和广泛使用，并有助于分析中心产生的价值和改善结果。
