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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...

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Detalles Bibliográficos
Autores principales: Kutner, Nancy G., Zhang, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
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.
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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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