Achieving equity in dialysis care and outcomes: The role of policies
Achieving equity in dialysis care and outcomes: The role of policies
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DOI：
10.1111/sdi.12847
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发表时间：
2020-01-03
影响因子：
1.6
通讯作者：
Novick, Tessa K.
中科院分区：
文献类型：
--
作者：
Crews, Deidra C.;Novick, Tessa K.
社会弱势群体，包括少数种族和族裔、低收入者、无家可归者和非美国公民，承受着不成比例的终末期肾病（ESKD）负担。在肾脏病转诊、血管通路、家庭透析方式的使用、肾移植和死亡率方面的不平等是突出的。公共政策，包括患者保护和平价医疗法案，终末期肾病质量激励计划和前瞻性支付系统，已颁布，以改善医疗保健和透析护理。在这里，我们强调透析护理和结果的不公平，当前ESKD和其他公共政策如何影响或加剧这些不公平，以及为实现ESKD公平的未来政策提供信息所需的文献空白。我们特别关注2019年推进美国肾脏健康行政命令，该命令具有从根本上改变透析护理的巨大潜力。
Socially disadvantaged persons, including racial and ethnic minorities, individuals with low incomes, homeless persons, and non-US citizens bear a disproportionate burden of end-stage kidney disease (ESKD). Inequities in nephrology referral, vascular access, use of home dialysis modalities, kidney transplantation, and mortality are prominent. Public policies, including the Patient Protection and Affordable Care Act, end-stage renal disease Quality Incentive Program, and the Prospective Payment System, were enacted to improve healthcare access and dialysis care. Here, we highlight inequities in dialysis care and outcomes, how current ESKD and other public policies may influence or exacerbate these inequities, and gaps in the literature needed to inform future policies toward achieving equity in ESKD. We give special attention to the 2019 Advancing American Kidney Health Executive Order, which has high potential to radically transform dialysis care.