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Learning from the implementation phase of the new French capitation payment model for chronic kidney disease care: a qualitative study.

作者信息

Raffray Maxime, Campéon Arnaud, Bricard Damien, Augé Estelle, Raynaud Denis, Couchoud Cécile, Frimat Luc, Bayat Sahar

机构信息

CNRS, Inserm, Arènes-UMR 6051, RSMS-U1309, École des hautes études en sante publique, Rennes, France.

Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Maria Aspmans Gata 22A, 171 64, Solna, Sweden.

出版信息

J Nephrol. 2025 Apr 22. doi: 10.1007/s40620-025-02284-8.


DOI:10.1007/s40620-025-02284-8
PMID:40261602
Abstract

BACKGROUND: France introduced a new payment model for care providers of patients with Chronic Kidney Disease (CKD) Grades 4 and 5: the CKD-Capitation Payment model. The model aims to financially incentivise multidisciplinary care for patients. We performed a qualitative study among participating providers to identify obstacles and facilitators of the model implementation as well as the initial benefits and potential policy improvements. METHODS: From March to July 2023, we collected data through semi-structured interviews with medical and managerial staff of facilities participating in the new model in France. We purposely selected a sample of facilities based on ownership status and CKD-Capitation Payment model activity data, including the number of patients reported. We performed a thematic analysis of the interview transcripts. RESULTS: We interviewed 22 staff from 14 facilities. Interviews revealed that adapting the information systems to the model requirements was a major obstacle to implementation, undermining efficient medical time allocation and data quality. Securing facility management support and organising the care amid workforce shortages were additional obstacles. Despite these challenges, staff reported positively on the model, noting the increased time spent by nurses with patients and the assertion of dietitians' role. Interviewees reported the need for greater flexibility in visit requirements to better align with patient needs. CONCLUSIONS: This study demonstrates how the new capitation payment model introduced in France can enable multidisciplinary and coordinated care for patients with CKD. However, supporting facilities in adopting interoperable information systems and increasing the flexibility of the model appear essential for long-term adoption.

摘要

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Learning from the implementation phase of the new French capitation payment model for chronic kidney disease care: a qualitative study.

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本文引用的文献

[1]
Chronic kidney disease and the global public health agenda: an international consensus.

Nat Rev Nephrol. 2024-7

[2]
Nurse Practitioner Care Compared with Primary Care or Nephrologist Care in Early CKD.

Clin J Am Soc Nephrol. 2023-12-1

[3]
Patient-Centered Outcomes With a Multidisciplinary CKD Care Team Approach: An Observational Study.

Kidney Med. 2023-1-20

[4]
Payment systems for dialysis and their effects: a scoping review.

BMC Health Serv Res. 2023-1-17

[5]
Healthcare resource utilisation and related costs of patients with CKD from the UK: a report from the DISCOVER CKD retrospective cohort.

Clin Kidney J. 2022-7-26

[6]
Increasing numbers and improved overall survival of patients on kidney replacement therapy over the last decade in Europe: an ERA Registry study.

Nephrol Dial Transplant. 2023-3-31

[7]
The Large Kidney Care Organizations' Experience With the New Kidney Models.

Adv Chronic Kidney Dis. 2022-1

[8]
Value-Based Care and Kidney Disease: Emergence and Future Opportunities.

Adv Chronic Kidney Dis. 2022-1

[9]
Predialysis Care Trajectories of Patients With ESKD Starting Dialysis in Emergency in France.

Kidney Int Rep. 2020-10-31

[10]
Frontline Perspectives on Physician Burnout and Strategies to Improve Well-Being: Interviews with Physicians and Health System Leaders.

J Gen Intern Med. 2020-1

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