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慢性肾脏病的跨学科护理诊所

Interdisciplinary care clinics in chronic kidney disease.

作者信息

Johns Tanya S, Yee Jerry, Smith-Jules Terrian, Campbell Ruth C, Bauer Carolyn

机构信息

Department of Medicine, Division of Nephrology, Albert Einstein School of Medicine, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA.

Department of Internal Medicine, Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.

出版信息

BMC Nephrol. 2015 Oct 12;16:161. doi: 10.1186/s12882-015-0158-6.

Abstract

The burden of chronic kidney disease (CKD) is substantial, and is associated with high hospitalization rates, premature deaths, and considerable health care costs. These factors provide strong rationale for quality improvement initiatives in CKD care. The interdisciplinary care clinic (IDC) has emerged as one solution to improving CKD care. The IDC team may include other physicians, advanced practice providers, nurses, dietitians, pharmacists, and social workers--all working together to provide effective care to patients with chronic kidney disease. Studies suggest that IDCs may improve patient education and preparedness prior to kidney failure, both of which have been associated with improved health outcomes. Interdisciplinary care may also delay the progression to end-stage renal disease and reduce mortality. While most studies suggest that IDC services are likely cost-effective, financing IDCs is challenging and many insurance providers do not pay for all of the services. There are also no robust long-term studies demonstrating the cost-effectiveness of IDCs. This review discusses IDC models and its potential impact on CKD care as well as some of the challenges that may be associated with implementing these clinics.

摘要

慢性肾脏病(CKD)的负担很重,与高住院率、过早死亡及高昂的医疗费用相关。这些因素为改善CKD护理的质量改进举措提供了有力依据。跨学科护理诊所(IDC)已成为改善CKD护理的一种解决方案。IDC团队可能包括其他医生、高级执业提供者、护士、营养师、药剂师和社会工作者——他们共同努力为慢性肾脏病患者提供有效的护理。研究表明,IDC可能会改善患者在肾衰竭前的教育和准备情况,而这两者都与改善健康结果相关。跨学科护理还可能延缓终末期肾病的进展并降低死亡率。虽然大多数研究表明IDC服务可能具有成本效益,但为IDC融资具有挑战性,许多保险提供商并不支付所有服务费用。也没有强有力的长期研究证明IDC的成本效益。本综述讨论了IDC模式及其对CKD护理的潜在影响,以及实施这些诊所可能面临的一些挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/663e/4603306/640fa1fa5c5c/12882_2015_158_Fig1_HTML.jpg

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