PROCESS, OUTCOME AND QUALITY OF CARE IN ESRD

本研究建议继续随访一组患者 在1995年至1998年间招募的新发终末期肾病患者。 的目的 该项目现在从比较血液透析和 腹膜透析患者（原项目的目的）的研究 各种过程测量和患者结果之间的关系。 结局包括死亡率、生活质量、患者满意度和 共病状态的发展。 主要研究队列包括 由一系列非营利性透析中心（80名参与者）护理的患者 中心）。 这个链条与研究有着持续的研究关系 调查人员和与母机构，约翰霍普金斯。 年度自我- 管理的患者调查和图表审查将提供大部分的 结果信息和一些关于护理过程的数据。 的主要来源 然而，关于护理过程的信息将是一份年度调查， 80个参与中心的主任询问了各种各样的 护理实践。 给出了几个与过程和结果相关的假设 具体目标部分。 调查人员还建议进行 使用自动化数据但无主要数据的辅助确证性分析 从这些中心收集更大的流行病例队列。 同样的主任调查将提供有关护理过程的信息， 预测器 结果仅限于生存。

This study proposes to continue follow-up of a cohort of patients with new onset ESRD who were recruited between 1995 and 1998. The purpose of the project now shifts from comparing outcomes between hemodialysis and peritoneal dialysis patients (the aim of the original project) to studying of the relation between a variety of process measures and patient outcomes. Outcomes include mortality, quality of life, patient satisfaction, and development of comorbid conditions. The primary study cohort consists of patients cared for by a chain of non-profit dialysis centers (80 participating centers). This chain has an ongoing research relationship with the study investigators and with the parent institution, Johns Hopkins. Annual self- administered patient surveys and chart review will provide most of the outcomes information and some data on care processes. The principal source of information on care processes, however, will be an annual survey sent to the directors of the 80 participating centers inquiring about a wide variety of care practices. Several hypotheses relating processes to outcomes are given in the specific aims section. The investigators also propose to conduct ancillary, confirmatory analyses using automated data but no primary data collection in a much larger cohort of prevalent cases from these same centers. The same director survey will provide information on care processes as predictors. Outcomes are limited to survival.