Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study
Objectives To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD).Design Analysis of data from a cross sectional national survey; the UK Renal Registry (...
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/4/e044984.full |
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| author | David Wellsted Ken Farrington Sabine N van der Veer Julia Jones Retha Steenkamp Janine Hawkins Nigel Smeeton Amanda Busby Beth Rider Catherine Stannard Rachel Gair Claire Corps |
| author_facet | David Wellsted Ken Farrington Sabine N van der Veer Julia Jones Retha Steenkamp Janine Hawkins Nigel Smeeton Amanda Busby Beth Rider Catherine Stannard Rachel Gair Claire Corps |
| author_sort | David Wellsted |
| collection | DOAJ |
| description | Objectives To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD).Design Analysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018).Setting National survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018.Participants The Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis—both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria.Main outcome measures The Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors.Results There were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9–710 patients per centre). There was significant variation in mean PREM score across centres (5.35–6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors.Conclusions Centre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience. |
| format | Article |
| id | doaj-art-2880b70a243e45bbac9a27d7fb016e84 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2880b70a243e45bbac9a27d7fb016e842024-11-18T05:45:12ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2020-044984Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional studyDavid Wellsted0Ken Farrington1Sabine N van der Veer2Julia Jones3Retha Steenkamp4Janine Hawkins5Nigel Smeeton6Amanda Busby7Beth Rider8Catherine Stannard9Rachel Gair10Claire Corps11Life and Medical Sciences, University of Hertfordshire, Hatfield, UKLife and Medical Sciences, University of Hertfordshire, Hatfield, UKCentre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UKCentre for Research in Primary & Community Care, University of Hertfordshire, Hatfield, UKUK Renal Registry, UK Kidney Association, Bristol, UKLife and Medical Sciences, University of Hertfordshire, Hatfield, UKHealth and Social Work, University of Hertfordshire, Hatfield, UK2University of Hertfordshire, Center for Health Services and Clinical Research and Post Graduate Medicine, Hatfield, United KingdomLife and Medical Sciences, University of Hertfordshire, Hatfield, UKpain transformation clinical lead and topic adviser for the guidelineUK Renal Registry, Renal Association, Bristol, UKSt James`s University Teaching Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UKObjectives To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD).Design Analysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018).Setting National survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018.Participants The Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis—both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria.Main outcome measures The Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors.Results There were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9–710 patients per centre). There was significant variation in mean PREM score across centres (5.35–6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors.Conclusions Centre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience.https://bmjopen.bmj.com/content/11/4/e044984.full |
| spellingShingle | David Wellsted Ken Farrington Sabine N van der Veer Julia Jones Retha Steenkamp Janine Hawkins Nigel Smeeton Amanda Busby Beth Rider Catherine Stannard Rachel Gair Claire Corps Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study BMJ Open |
| title | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
| title_full | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
| title_fullStr | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
| title_full_unstemmed | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
| title_short | Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study |
| title_sort | contributions of treatment centre and patient characteristics to patient reported experience of haemodialysis a national cross sectional study |
| url | https://bmjopen.bmj.com/content/11/4/e044984.full |
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