243717 Hospitalization utilization and multidisciplinary care on chronic kidney diseases patients

Sunday, October 30, 2011

Yu Yang, Taiwan, ROC , Division of Nephrology, Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
Wen-Yu Chou, Taiwan, ROC , Division of Nephrology, Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
Shu-Chuan Wang, Taiwan, ROC , Division of Nephrology, Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
Shu-Ya Chen, Taiwan, ROC , Division of Nephrology and chronic disease education center, Changhua Christian Hospital, Changhua, Taiwan
Chih-Ying Huang, Taiwan, ROC , Division of Nephrology and chronic disease education center, Changhua Christian Hospital, Changhua, Taiwan
Shih-Yi Yang, Taiwan, ROC , Division of Nephrology, Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
Yao-Peng Sie, Taiwan, ROC , Division of Nephrology, Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
A cohort study was conducted during 2007 and 2010, and this is a preliminary result of the 1st stage study at the year of 2008. Subjects aged 20-80 years old, estimated glomerular filtration rate (eGFR) between 10 and 60ml/min were enrolled. Study subjects were categorized as non-multidisciplinary care (non-MDC) group and MDC group. Purposive sampling was randomly matched on gender, age and eGFR at a ratio of 1:1. Finally, 506 study subjects (253 pairs) were enrolled in our study. Result:The mean age was 65.2 years and 67.2% of subjects were men. There were 75.0% subjects married and 64.2% less educated. The prevalence of cardiovascular diseases was higher in non-MDC group. MDC group had higher creatinine, albumin, high-density lipoprotein cholesterol (HDL) and serum Na level; MDC group had lower HbA1C significantly (p<0.05). MDC group had higher significantly prescription rate of ACEI/ARB, phosphate binders and uric acid control agents than non-MDC group (p<0.05). During 1st year follow up, lower hospitalization day (1.264.70 vs. 3.381.89), the frequency of hospitalization (0.190.56 vs. 0.320.71) and hospitalization rate (13.04% vs. 20.95%) were noted in MDC group significantly (p<0.05). Conclusion:Among chronic kidney diseases patients, multidisciplinary care is associated with superior biochemical outcomes, better medicine therapy and fewer hospitalization utilization especially significantly benefit in high economic burden caused by end-stage renal diseases (ESRD) in Taiwan.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Epidemiology
Program planning
Public health or related education
Public health or related research

Learning Objectives:
To evaluate hospitalization utilization on chronic kidney diseases patients under multidisciplinary care (MDC) at three chartered hospital in Taiwan.

Keywords: Chronic Diseases, Medical Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I manage CKD center, construct and evaluate the model of CKD and multiple disciplinary care team.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.