Evaluation of Quality of Care - Haemodialysis Public-Private-Partnership, Hospital Authority (QoC HDPPP)
Evaluation of Quality of Care - Haemodialysis Public-Private-Partnership, Hospital Authority (HA)
Patients with end-stage renal failure (ESRF) have lost the function to excrete urea and maintain electrolyte balance, which is lethal unless they are given renal replacement therapy (Gibney, Hoste et al. 2008). As one of the initiatives of service improvement, the HA has introduced the haemodialysis public-private partnership (HD PPP) programme to shorten the waiting time for patients with ESRF needing HD treatment. HD PPP programme is a new service provision model that purchases healthcare services from non-Government healthcare organizations. The evaluation on the quality of care (QOC) is an essential part of the programme in order to inform future policy. The Department of Family Medicine and Primary Care of the University of Hong Kong has been appointed by the HA to carry out the evaluation of the QOC of the programme.
The Action Learning and Audit Spiral methodologies to measure whether the target standard of care intended by the HD PPP programme is achieved. Each HD PPP participating hospitals and centers will be invited to complete a structure evaluation questionnaire. Sixty patients who have agreed to join HD PPP and 60 control patients who have refused to take part in HD PPP will be included. The participants will be followed up by telephone to evaluate the effect of the programme on quality of life (QOL), patient enablement, and global rating of change in health condition. Data on the process of care and clinical outcomes of care will be retrieved from the HA medical records.
Main Outcome Measures: The primary outcomes are the proportion of participants who have received the planned process of care and adequate haemodialysis (HD) measured by the Kt/V
Data Analysis: Descriptive statistics on proportions meeting the QOC criteria will be calculated. The outcomes of HD PPP subjects will be compared at 6, 12, 24, 36 and 48 months by paired sample t-test. The outcomes between HD PPP subjects and control group will be compared by independent sample t-test or Chi-square test.
Results: The QOC of the HD PPP programme will be determined. Areas of deficiency and possible areas for quality enhancement will be identified.
Conclusion: The results of this study will provide empirical evidence on whether the HD PPP can achieve equivalent QOC as the usual HA care in order to guide service planning and policy decision making for patients with ESRF.
研究概览
地位
研究类型
注册 (实际的)
联系人和位置
学习地点
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-
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Hong Kong Island、香港
- The University of Hong Kong
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-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Patients currently being followed up at the HA on haemodialysis, peritoneal dialysis, or are new ESRF cases will be recruited.
Exclusion Criteria:
- Patients who do not have a good vascular access, are not hemodynamically stable for HD, are not mentally sound, ambulatory and independent, are unable to understand and communicate in Chinese language, or refuse to give consent will be excluded from the HD PPP programme.
学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
|---|
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End-stage renal failure (ESRF)
end-stage renal failure (ESRF)
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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The proportion of centers that have satisfied each of the set structure criteria.
大体时间：Five years
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Interim analysis will evaluate in October, 2010; October, 2011; October, 2012; October, 2013; October, 2014
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Five years
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The proportion of patients who have complied with the HD PPP process of care.
大体时间：Five years
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Interim analysis will evaluate in June, 2011; December, 2011; December, 2012; December, 2013; December, 2014
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Five years
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The proportion of patients who have adequate HD measured by the Kt/V.
大体时间：Five years
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Interim analysis will evaluate in June, 2011; December, 2011, December, 2012; December, 2013; December, 2014
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Five years
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Clinical outcomes include decompensation episodes, pre-dialysis serum calcium level, blood pressure (BP), LDL-C, patient mortality and adverse clinical events.
大体时间：Five years
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Baseline, 6, 12, 24, 36, 48 months after enrolment
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Five years
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Patient reported outcomes (PRO) are measured by the change in Short Form -12v2 scores, the Patient ennoblement index and Global Rating of Change Scale scores
大体时间：Five years
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Baseline and 6-month/12-month/24-month/36-month after the first administration of questionnaire.
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Five years
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Service utilization outcomes are measured by General Out-patient Clinics consultation, renal Specialist Out-patient Clinics consultation, A&E attendance rates and hospitalization rate in the past 12 months.
大体时间：Five years
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Baseline and 12 months for each subject; the audit cycle will be repeated annually over a period of 5 years.
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Five years
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合作者和调查者
调查人员
- 学习椅：Cindy L.K. Lam, MD、Department of Family Medicine and Primary Care, Faculty of Medicine, The University of Hong Kong
- 首席研究员：Julie Chen, MD、Department of Family Medicine and Primary Care, Faculity of Medicine, The University of Hong Kong
出版物和有用的链接
一般刊物
- Wan EY, Chen JY, Choi EP, Wong CK, Chan AK, Chan KH, Lam CL. Patterns of health-related quality of life and associated factors in Chinese patients undergoing haemodialysis. Health Qual Life Outcomes. 2015 Jul 29;13:108. doi: 10.1186/s12955-015-0308-3.
- Chen JY, Choi EP, Wan EY, Chan AK, Tsang JP, Chan KH, Lo WK, Lui SL, Chu WL, Lam CL. Validation of the Disease-Specific Components of the Kidney Disease Quality of Life-36 (KDQOL-36) in Chinese Patients Undergoing Maintenance Dialysis. PLoS One. 2016 May 5;11(5):e0155188. doi: 10.1371/journal.pone.0155188. eCollection 2016.
- Chen JY, Wan EY, Chan KH, Chan AK, Chan FW, Lam CL. Evaluation of the quality of care of a haemodialysis public-private partnership programme for patients with end-stage renal disease. BMC Nephrol. 2016 Jul 11;17(1):79. doi: 10.1186/s12882-016-0284-9.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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