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- Title
Clinical outcomes of hemodialysis patients in a public-private partnership care framework in Italy: a retrospective cohort study.
- Authors
Pedrini, L. A.; Winter, A. C.; Cerino, F.; Zawada, A. M.; Garbelli, M.; Feuersenger, A.; Feliciani, A.; Ruggiero, P.; Civardi, S.; Amato, C.; Canaud, B.; Stuard, S.; Karch, A.; Gauly, A.
- Abstract
<bold>Background: </bold>Innovative care models such as public-private partnerships (PPPs) may help meet the challenge of providing cost-effective high-quality care for the steadily growing and complex chronic kidney disease population since they combine the expertise and efficiency of a specialized dialysis provider with the population care approach of a public entity. We report the five-years main clinical outcomes of a population of patients treated on hemodialysis within a PPP-care model in Italy.<bold>Methods: </bold>This descriptive retrospective cohort study consisted of all consecutive hemodialysis patients treated in the NephroCare-operated Nephrology and Dialysis unit of the Seriate Hospital in 2012-2016, which exercises a PPP-care model. Clinical and treatment information was obtained from the European Clinical Database. Hospitalization outcomes and cumulative all-cause mortality incidences that accounted for competing risks were calculated.<bold>Results: </bold>We included 401 hemodialysis patients (197 prevalent and 204 incident patients) in our study. The mean cohort age and age-adjusted Charlson Comorbidity Index were 67.0 years and 6.7, respectively. Patients were treated with online high-volume hemodiafiltration or high-flux hemodialysis. Parameters of treatment efficiency were above the recommended targets throughout the study period. Patients in the PPP experienced benefits in terms of hospitalization (average number of hospital admissions/patient-year: 0.79 and 1.13 for prevalent and incident patients, respectively; average length of hospitalization: 8.9 days for both groups) and had low cumulative all-cause mortality rates (12 months: 10.6 and 7.8%, 5 years: 42.0 and 35.9%, for prevalent and incident patients, respectively).<bold>Conclusions: </bold>Results of our descriptive study suggest that hemodialysis patients treated within a PPP-care model framework received care complying with recommended treatment targets and may benefit in terms of hospitalization and mortality outcomes.
- Subjects
ITALY; HEMODIALYSIS patients; PUBLIC-private sector cooperation; COHORT analysis; COMPETING risks; HEMODIAFILTRATION
- Publication
BMC Nephrology, 2019, Vol 20, Issue 1, pN.PAG
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-019-1224-2