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Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics
Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the abilit...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618170/ https://www.ncbi.nlm.nih.gov/pubmed/28783094 http://dx.doi.org/10.3390/healthcare5030042 |
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author | Kutner, Nancy G. Zhang, Rebecca |
author_facet | Kutner, Nancy G. Zhang, Rebecca |
author_sort | Kutner, Nancy G. |
collection | PubMed |
description | Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression—an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients’ top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes. |
format | Online Article Text |
id | pubmed-5618170 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-56181702017-09-29 Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics Kutner, Nancy G. Zhang, Rebecca Healthcare (Basel) Article Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression—an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients’ top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes. MDPI 2017-08-07 /pmc/articles/PMC5618170/ /pubmed/28783094 http://dx.doi.org/10.3390/healthcare5030042 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kutner, Nancy G. Zhang, Rebecca Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title | Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title_full | Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title_fullStr | Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title_full_unstemmed | Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title_short | Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics |
title_sort | ability to work among patients with eskd: relevance of quality care metrics |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618170/ https://www.ncbi.nlm.nih.gov/pubmed/28783094 http://dx.doi.org/10.3390/healthcare5030042 |
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