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Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study
OBJECTIVES: To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD). DESIGN: Analysis of data from a cross sectional national survey; the UK Renal Registr...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054084/ https://www.ncbi.nlm.nih.gov/pubmed/33853800 http://dx.doi.org/10.1136/bmjopen-2020-044984 |
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author | Hawkins, Janine Smeeton, Nigel Busby, Amanda Wellsted, David Rider, Beth Jones, Julia Steenkamp, Retha Stannard, Catherine Gair, Rachel van der Veer, Sabine N Corps, Claire Farrington, Ken |
author_facet | Hawkins, Janine Smeeton, Nigel Busby, Amanda Wellsted, David Rider, Beth Jones, Julia Steenkamp, Retha Stannard, Catherine Gair, Rachel van der Veer, Sabine N Corps, Claire Farrington, Ken |
author_sort | Hawkins, Janine |
collection | PubMed |
description | OBJECTIVES: To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD). DESIGN: Analysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018). SETTING: National survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018. PARTICIPANTS: The Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis—both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria. MAIN OUTCOME MEASURES: The Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors. RESULTS: There were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9–710 patients per centre). There was significant variation in mean PREM score across centres (5.35–6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors. CONCLUSIONS: Centre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience. |
format | Online Article Text |
id | pubmed-8054084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-80540842021-04-28 Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study Hawkins, Janine Smeeton, Nigel Busby, Amanda Wellsted, David Rider, Beth Jones, Julia Steenkamp, Retha Stannard, Catherine Gair, Rachel van der Veer, Sabine N Corps, Claire Farrington, Ken BMJ Open Renal Medicine OBJECTIVES: To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD). DESIGN: Analysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018). SETTING: National survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018. PARTICIPANTS: The Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis—both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria. MAIN OUTCOME MEASURES: The Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors. RESULTS: There were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9–710 patients per centre). There was significant variation in mean PREM score across centres (5.35–6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors. CONCLUSIONS: Centre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience. BMJ Publishing Group 2021-04-14 /pmc/articles/PMC8054084/ /pubmed/33853800 http://dx.doi.org/10.1136/bmjopen-2020-044984 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Renal Medicine Hawkins, Janine Smeeton, Nigel Busby, Amanda Wellsted, David Rider, Beth Jones, Julia Steenkamp, Retha Stannard, Catherine Gair, Rachel van der Veer, Sabine N Corps, Claire Farrington, Ken Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title_full | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title_fullStr | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title_full_unstemmed | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title_short | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
title_sort | contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
topic | Renal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054084/ https://www.ncbi.nlm.nih.gov/pubmed/33853800 http://dx.doi.org/10.1136/bmjopen-2020-044984 |
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