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The integrated management for renal replacement therapy in Portugal

dc.contributor.authorCoelho, Anabela P.
dc.contributor.authorSá, Helena O.
dc.contributor.authorDiniz, José A.
dc.contributor.authorDussault, Gilles
dc.date.accessioned2015-10-14T15:12:06Z
dc.date.available2015-10-14T15:12:06Z
dc.date.issued2014
dc.description.abstractPortugal was the first European country to introduce an integrated management of end-stage renal disease (IM ESRD). This new program integrates various dialysis services and products, which are reimbursed at a fixed rate/patient/week called “comprehensive price payment.” This initiative restructured the delivery of dialysis services, the monitoring of outcomes, and the funding of renal replacement therapy. This article described the implementation of a new model of comprehensive provision of hemodialysis (HD) services and aimed to assess its impact on dialysis care. Quality assessments and reports of patient satisfaction, produced by the Ministry of Health since 2008, as well as national registries and reports, provided the data for this review. Indicators of HD services in all continental facilities show positive results that have successively improved along the period of 2009–2011, in spite of an average annual growth of 3% of the population under HD treatment. Mortality rates for HD patients were 12.7%, 12%, and 11%, respectively in 2009, 2010, and 2011; annual hospitalization rates were 4.9%, 3.8%, and 4.4% for the same years; key performance indicators showed averages above the reference values such as hemoglobin, serum phosphorus, eKt/V, water quality, number of days of hospitalization per patient per year, and number of weekly dialysis sessions. The financing analysis of IM ESRD demonstrates a sustained control of global costs, without compromising quality. The IM ERSD program is an innovative and quality-driven approach that benefits both dialysis patients and providers, contributing toward the rationalization of service provision and the efficient use of resources.pt_PT
dc.identifier.doiDOI:10.1111/hdi.12064
dc.identifier.urihttp://hdl.handle.net/10400.26/9928
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherInternational Society for Hemodialysispt_PT
dc.relation.publisherversionhttp://onlinelibrary.wiley.com/doi/10.1111/hdi.12064/abstract;jsessionid=CA876FF936440CD550EDC2401DE93A7B.f01t03pt_PT
dc.subjectHemodiálisept_PT
dc.subjectGestão Integrada da Doençapt_PT
dc.subjectDoença Renalpt_PT
dc.subjectPortugalpt_PT
dc.titleThe integrated management for renal replacement therapy in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage184pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage175pt_PT
oaire.citation.titleHemodialysis Internationalpt_PT
oaire.citation.volume18pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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