| Summary: | 碩士 === 中國醫藥大學 === 公共衛生學系碩士班 === 99 === Objective: The aim of this study is to examine the influence of the creation of pre-dialysis access on health care utilization and dialysis quality for patients with the end-stage renal diseases.
Method: The study subjects were from a public hospital in Chang-Hua County, and followed up from Jan 1st, 2008 to Feb 28th, 2011. A total of 101 ESRD patients with ICD-9 CM code of 585 were in hemodialysis or peritoneal dialysis therapy. The data on age, sex, educational levels, ever having chronic kidney education program or not before the first time dialysis, and the biomarker values on dialysis quality were collected from chart records, and the medical utilization were from the inpatient declaration values to national health insurance .
Result: The medical utilization was less for patients with the creation of pre-dialysis access before the first-time dialysis therapy than that for patients without. The changes in the the biomarker values of dialysis quality, Hematocrite, KT/V and Almumin, presented positive trends for patients with the creation of pre-dialysis access; but the trends reversed for BUN and Creatinine. These reversed trends may be attributed to the worse renal status for patients without the precreation access, which in turn resulting in larger increased changes after the following dialysis therapy.
Conclusion: This study suggested that creating pre-dialysis access before the first time dialysis be able to decrease the medical utilization and have helpful effects on the progress for dialysis therapy for the ESRD patients.
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