Clinical journal of the American Society of Nephrology : CJASN · 2009
An investigation of satellite hemodialysis fallbacks in the province of Ontario.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lindsay Robert M, Hux Janet, Holland David, Nadler Steven, Richardson Robert, Lok Charmaine, Moist Louise, Churchill David
Аннотация
BACKGROUND AND OBJECTIVES: In Ontario, Canada, hemodialysis services are organized in a "hub and spoke" model comprised of regional centers (hubs), satellites, and independent health facilities (IHFs; spokes). Rarely is a nephrologist on site when dialysis treatments take place at satellite units or IHFs. Situations occur that require transfer of the patient back ("fallbacks") to the regional center that necessitate either in- or outpatient care. Growth in the satellite dialysis population has led to an increased burden on the regional centers. This study was carried out to determine the incidence, nature, and outcome of such fallbacks to aid resource planning.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were collected on 565 patients from five regional centers over 1 yr. These regional centers controlled 19 satellite dialysis centers including 7 IHFs.
RESULTS: There were 681 fallbacks in 328 patients: 1.21 incidents per patient or 2.1 incidents per patient year. Multiple fallbacks occurred in 170 patients. Fallback episodes lasted a mean of 10.3 d, requiring 4.6 dialysis treatments. Forty-five percent of fallbacks required hospitalization with a mean stay of 16.7 d. Access-related problems (33%) and nondialysis medical causes (32%) were the major causes of fallback. Resolution of the problem occurred in 87.8%, with the patient returning to the satellite. By the end of the study 77.3% were still satellite patients, 10.8% died, 3.8% returned to the regional center, 3.4% were transplanted, and 4.7% were transferred to other treatment modalities.
CONCLUSIONS: Fallbacks are common, yet the model operates well.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were collected on 565 patients from five regional centers over 1 yr. These regional centers controlled 19 satellite dialysis centers including 7 IHFs.
RESULTS: There were 681 fallbacks in 328 patients: 1.21 incidents per patient or 2.1 incidents per patient year. Multiple fallbacks occurred in 170 patients. Fallback episodes lasted a mean of 10.3 d, requiring 4.6 dialysis treatments. Forty-five percent of fallbacks required hospitalization with a mean stay of 16.7 d. Access-related problems (33%) and nondialysis medical causes (32%) were the major causes of fallback. Resolution of the problem occurred in 87.8%, with the patient returning to the satellite. By the end of the study 77.3% were still satellite patients, 10.8% died, 3.8% returned to the regional center, 3.4% were transplanted, and 4.7% were transferred to other treatment modalities.
CONCLUSIONS: Fallbacks are common, yet the model operates well.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overCommunity Health CentersDelivery of Health CareFemaleHospitalizationHospitals, SatelliteHumansKidney TransplantationLength of StayMaleMiddle AgedNational Health ProgramsNephrologyOntarioOutcome and Process Assessment, Health CarePatient TransferPersonnel Staffing and SchedulingRegional Health PlanningRenal DialysisRisk AssessmentRisk FactorsTreatment OutcomeYoung Adult