PROCESS, OUTCOME AND QUALITY OF CARE IN ESRD

这项研究建议继续对一组患者进行随访 在1995至1998年间招募的新发病的终末期肾病。目的 该项目现在从比较血液透析和 腹膜透析患者(原项目目的)对腹膜透析患者的研究 各种过程措施与患者预后之间的关系。 结果包括死亡率、生活质量、患者满意度和 并存情况的发展。主要研究队列包括 由一系列非营利性透析中心护理的患者(80人参与 中心)。这个链条与研究有持续的研究关系 调查人员和母公司约翰斯·霍普金斯大学。年度自我评估- 管理的患者调查和图表审查将提供大部分 结果信息和有关护理过程的一些数据。的主要来源 然而，有关护理过程的信息将是发送给 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 在具体目标部分。调查人员还提议进行 使用自动化数据但不使用主要数据的辅助验证性分析 从这些中心收集了一个更大的流行病例队列。 相同的主任调查将提供有关护理过程的信息，如 预测者。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.