CKD Care Programs and Incident Kidney Failure: A Study of a National Disease Management Program in Taiwan.
Kidney Med
; 4(7): 100485, 2022 Jul.
Article
em En
| MEDLINE
| ID: mdl-35812528
ABSTRACT
Rationale & Objective:
Taiwan implemented national pay-for-performance programs for chronic kidney disease (CKD) care in 2006 and 2011; however, it is unknown whether this affected trends in maintenance dialysis. This study assessed the temporal trends in the incidence, prevalence, and mortality of individuals treated with maintenance dialysis from 2002-2016 in Taiwan. StudyDesign:
Follow-up study using Taiwan Renal Disease System Databases. Setting &Participants:
Participants who received dialysis for ≥90 days. Predictors Age, sex, and calendar year.Outcomes:
Incidence, prevalence of maintenance dialysis, or death, ascertained using the National Death Registry database. AnalyticalApproach:
The estimated annual percentage change was assessed by a generalized linear model, and the association of the programs with changes in the incidence of maintenance dialysis was evaluated using an age-period-cohort model.Results:
A total of 144,258 incident cases with a follow-up of 346 million person-years were analyzed during the observed periods. The estimated annual percentage change of the expected crude incidence rate was slightly reduced by 0.41% (95% CI, -1.06 to 0.24) and was more obvious in women and patients aged greater than 70 years; whereas, it was significantly increased in those aged greater than 75 years. After disentangling age and cohort effects, the implementation of the care programs was associated with an overall net drift of -1.09% (95% CI, -1.65 to -0.52) per year and a significant linear reduction in the period rate ratio from 1.06 (95% CI, 1.02-1.09) in the years 2002-2006 to 0.95 (95% CI, 0.92-0.98) in 2012-2016, using years 2007-2011 as reference.Limitations:
The findings of the study may have limited inferences to other countries with different health care systems.Conclusions:
The implementation of universal CKD care programs in Taiwan has significantly reduced the long-term trends in the incidence of maintenance dialysis; hence, devoting governmental resources to CKD care and prevention is advocated.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Kidney Med
Ano de publicação:
2022
Tipo de documento:
Article