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Dialysis Centres (dialysis + centre)
Selected AbstractsCost of renal replacement therapy in TurkeyNEPHROLOGY, Issue 1 2004EKREM EREK SUMMARY: Background and Results: By the end 2000, 22 224 patients were on renal replacement therapy (RRT) in Turkey. We investigated the cost of RRT in three medical faculties and one private dialysis centre. Yearly expenses were US$22 759 for haemodialysis (HD), US$22 350 for continuous ambulatory peritoneal dialysis (CAPD), and US$23 393 and US$10 028, respectively, for the first and second years of transplantation (Tx). In the first year, renal Tx was significantly more expensive than CAPD. However, after the first year of renal transplantation, Tx became significantly more economical than both CAPD and HD. The sum of all yearly RRT expenses for the country was US$488 958 709, which corresponds to nearly 5.5% of Turkey's total health expenditure. Conclusion: Measures such as early construction of vascular access, promoting home dialysis and the reuse of the dialysers, strict control of the use of some expensive drugs like erythropoietin and active vitamin D, and also increasing the number of transplantations, especially if pre-emptive transplantation is possible, should be taken into account in order to reduce these expenses. [source] Lack of de novo hepatitis C virus infections and absence of nosocomial transmissions of GB virus C in a large cohort of German haemodialysis patientsJOURNAL OF VIRAL HEPATITIS, Issue 4 2009R. S. Ross Summary., To determine the prevalence and incidence of hepatitis C virus (HCV) infections among haemodialysis patients, a large prospective multicentre trial was conducted in the German Federal State of North Rhine-Westphalia. Sera obtained from the recruited patients in two separate sampling rounds run 1 year apart were analysed for both anti-HCV antibodies and HCV RNA. HCV RNA positive samples were also genotyped by direct sequencing of an HCV core fragment. In the first and second rounds, 150 (5.2%) of 2909 and 114 (5.4%) of 2100 patients were anti-HCV positive, respectively, and 4% of individuals were viraemic. Evaluation of potential risk factors in a case,control study indicated that the factors ,foreign country of birth', ,blood transfusions given before 1991' and ,duration of treatment on haemodialysis' were associated with the risk of HCV infection. Among the 2100 patients of whom ,paired' serum samples from both rounds were available for testing, not a single ,de novo' HCV infection could be recorded. The fact that in a subset of about 20% of these patients no nosocomial GB virus C (GBV-C) transmission occurred during the observational period suggests that the lack of HCV seroconversions was not only attributable to the isolation of HCV-infected patients but also to the strict adherence to so-called universal hygienic precautions for infection control maintained in the participating dialysis centres. [source] Current status of dialytic therapy in KoreaNEPHROLOGY, Issue 2003Suk Young KIM SUMMARY: The status of dialytic therapy in Korea at the end of 2001 was reported by the end-stage renal disease (ESRD) registry committee of Korean Society of Nephrology, where data were collected through an internet on-line registry program. The number of dialysis centres was 335 and the number of haemodialysis machines was 5529. The total number of patients with dialysis was 23 057 (haemodialysis 17 568, peritoneal dialysis 5489). Prevalence and incidence of dialysis patients were 477.5 and 96.4 patients per million population. The most common primary cause of end-stage renal diseases was diabetic nephropathy (41.5%), hypertensive nephrosclerosis (15.4%), and chronic glomerulonephritis (13.6%). Eighty-six percent of haemodialysis patients were on dialysis therapy three times a week, the mean urea reduction ratio was 66.7 ± 8.68% and mean Kt/V was 1.250 ± 0.292 in male patients; 1.526 ± 0.361 in female patients. The technical survival of haemodialysis in 5 years was 30.2% and peritoneal dialysis was 13.8%. The common complication of haemodialysis patients was hypertension (43.3%), gastrointestinal disease other than peptic ulcer (8.0%), congestive heart failure (7.6%), and of peritoneal dialysis patients were also hypertension (28.8%), congestive heart failure (5.0%), and peritonitis (4.8%). The most common causes of death were cardiac diseases (26.9%), vascular diseases, including cerebrovascular accidents (22.7%), and infection (17.8%). [source] LEARNING ISSUES FOR NURSES IN RENAL SATELLITE CENTRESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2000Sally Wellard ABSTRACT: The introduction of ,satellite' dialysis centres has increased local access to renal services for patients living in rural and remote areas across Australia and is, therefore, consistent with rural health policies. Rural health strategies also aim to maintain and improve the skills of health professionals through regular review of the scope of their practice and evaluation of the education required. Yet, the results of the present national study of nurses working in satellite dialysis centres indicate that, for many, the context of practice influences their ability to access ongoing professional education to support and extend their nursing practice. The present study showed that there was a range of educational backgrounds among nurses working in rural ,satellite' centres with reportedly limited access to specific dialysis-related professional development. In the present paper we report on factors that influence the ability of nurses working in satellite dialysis centres to access ongoing professional education. [source] La diffusion d'une innovation portant les germes de son plafonnement: la réutilisation des hémodialyseurs au QuébecCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 3 2001Daniel Lozeau Sommaire: L'objectif de cette recherche est d'identifier les facteurs de diffusion d'une innovation - la réutilisation des hémodialyseurs (rh) - ainsi que de son plafonncment marqué par la controverse, à travers les motivations et stratégies des groupes d'acteurs clés. Plus particulièrement, cette étude vise à situer le rôle de la " médecine fondée sur des données probantes "dans la dynamique de la diffusion de cette innovation. Nous partons du constat que la rh est une pratique reconnue pour les économies qu'elle génère tout en étant perçue par certains comme risquée pour la santé des usagers et du personnel. Les résultats de notre étude montrent que la diffusion de la rh au Québec, loin d'avoir pris son assise sur des données empiriques solides, a plutôt résulté de comportements sociaux d'imitation à la faveur de contacts directs entre des centres de dialyse voisins qui subissaient alors de fortes pressions de leurs autorités afin de réduire leurs dépenses. Cependant, l'ampleur des investissements nécessaires à l'introduction de cette pratique, la perspective de devoir négocicr I'achat de matériel dédiéà la rh auprès d'un monopole, ainsi que les stratégies commerciales de fournisseurs peu motivés à promouvoir la vente de matériel de rh au détriment de celle, plus lucrative, d'hémodialyseurs en grande quantité (lorsque non réutilisés), ont grandement réduit l'attrait économique dc la rh aux yeux des dirigeants de centres de dialyse. L'incapacité des données empiriques à endiguer les craintes soulevées par les risques associés à la rh a eu la double conséquence (1) dc mener au plafonnement de cette activité et (2) d'induire des centres de dialysc qui effectuaient déjà la rh à se doter d'une gestion envers les patients basée sur la non transparence et la contrainte. Sur le plan conceptuel, les résultats de cette étude montrent que ce n'est que dans la mesure où les facteurs sociaux et d'intérêts (dynamiquc institutionnelle) sont pris en compte et qu'ils convergent avec les critères de rationalité technique, qu'une innovation améliore ses chances de se diffuser et de s'enraciner dans une organisation. Considérant ces conclusions, quelques propositions sont énonées dans le but d'améliorer le potentiel d'implantation de la rh en facilitant la prise en compte des données empiriques dans les centres de dialyse, tout en leur procurant un meilleur rapport de force vis-à-vis leurs fournisseurs et afin que les patients et le personnel clinique y trouvent davantage leur intérêt. Abstract: The purpose of this research is to identify the factors in the diffusion of an innovation - hemodialyzer re-use - and the controversy surrounding the levelling off of its use, by looking at the motivations and strategies of key actors. More particularly, this study focuses on the role of "evidence-based medicine" in the diffusion of this innovation. Starting with the observation that hemodialyzer re-use is recognized for its cost-savings while being perceived by some to be a health risk for both users and staff, our findings show that diffusion of this practice in Quebec, far from being based on solid empirical data, was instead influenced by the social phenomenon of imitation that resulted from direct contact with local dialysis centres that were at the time under great pressure from their management to reduce expenditures. The cost-savings of hemodialyzer re-use for the people managing the dialysis centres was, however, greatly reduced by several factors: the considerable investments needed to introduce this practice; the prospects of having to negotiate with a monopoly to purchase the hemodialyzer-dedicated equipment; and the commercial strategies of suppliers who have little interest in promoting the sale of equipment for hemodialyzer re-use over the more lucrative sale of large quantities of hemodialyzers (when not re-used). The ineffectiveness of empirical data in allaying fears of the risks associated with the practice of hemodialyzer re-use has had the dual effect of 1) causing this activity to level off, and 2) causing dialysis centres already involved in hemodialyzer re-use to adopt an approach to patient management that is based on non-transparency and constraint. On the conceptual level, our findings show that the likelihood of an organization adopting an innovation increases when social factors and interest factors (such as the institutional dynamic) are taken into account and align with criteria of technical rationality. Given these conclusions, we put forward some proposals for improving the potential of hemodialyzer re-use by facilitating the dialysis centres' consideration of empirical data. As well, our proposals are aimed at obtaining a stronger position for the centres with regard to their suppliers and at ensuring that both patients and clinic staff benefit more from the practice of hemodialyzer re-use. [source] | ||||||||||