The Team Approach to the Management of Children on Chronic Peritoneal Dialysis

Harvey, Elizabeth; Secker, Donna; Braj, B; Picone, Gail; Balfe, J. Williamson

doi:10.1016/s1073-4449(96)80036-7

Cited by 17 publications

(8 citation statements)

References 36 publications

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“…This is an important factor in adult studies of dialysis modality choice; however, it may not be as crucial in pediatrics, as there are few conditions other than abdominal wall defects and membrane failure that are absolute contraindications to the use of PD in children. 19 In addition, adjusting for socioeconomic status on the basis of zip code-based census data may not be as desirable as using patient specific income or education. However, recent studies have provided evidence that zip code-based measures of socioeconomic status are robust and reliable proxies for patient socioeconomic conditions.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Choice of Dialysis Modality for Children With End-stage Renal Disease

et al. 1997

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ABSTRACT. Objective. Black-white disparities in the use of specific medical and surgical services have been reported in adult populations. Such disparities are not well documented in children. We sought to determine whether racial disparities in the use of medical services exist among children with chronic illness who have similar health insurance, specifically the choice of dialysis modality for individuals with end-stage renal disease.Design. National cross-sectional study. Setting. Outpatient dialysis facilities throughout the United States.Patients and Participants. All Medicare-eligible children (age, 19 years) undergoing renal replacement therapy in 1990 in the United States, using data from the Medicare ESRD registry.Outcome Measures. The odds of receiving hemodialysis versus peritoneal dialysis according to race. Adjustment was made for differences in age, gender, cause, and duration of end-stage renal disease, income, education, and facility chracteristics using multiple logistic regression.Results. In 1990, 870 white and 368 black children received chronic (>1 year) renal replacement therapy in the United States. In bivariate analysis, blacks were two times (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.7, 2.8) more likely than whites to receive hemodialysis versus peritoneal dialysis. After controlling for other patient and facility characteristics in multivariate analysis, black children were still significantly more likely than white children to receive hemodialysis (OR, 2.4; 95% CI, 1.7, 3.5).Conclusions. Black race is strongly associated with the use of hemodialysis in children. Family, patient, or provider preferences could account for the difference in choice of therapy by race. Pediatrics 1997;99(4). URL: http://www.pediatrics.org/cgi/content/full/99/4/e6; chronic renal failure, children; racial disparities, peritoneal dialysis, health insurance.ABBREVIATIONS. ESRD, end-stage renal disease; HD, hemodialysis; PD, peritoneal dialysis; RRT, renal replacement therapy.In 1990, the Council on Ethical and Judicial Affairs of the American Medical Association called for the elimination of racial disparities in medical treatment decisions in the United States.1 They urged physicians to examine their own practices and for the profession to "increase the awareness of racial disparities in medical treatment decisions through broad discussion of the issue."1 While black-white disparities in treatment options have been previously documented in adults, particularly in nephrology, 2,3 cardiology, 4 cardiac surgery, 5 obstetrics, 1 and general internal medicine, 6 this issue has not been explored fully in populations cared for by general or subspecialty pediatricians.7 Black-white disparities in use of medical services can be confounded by differences in health insurance status making this issue difficult to examine. One population in which primary health insurance differences do not exist is in end-stage renal disease (ESRD) patients covered by Medicare insurance.Recently, lower rates in initiation of p...

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Section: Discussionmentioning

confidence: 99%

Racial Differences in Choice of Dialysis Modality for Children With End-stage Renal Disease

et al. 1997

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“…Understanding adaptation problems, encouraging adherence and giving fresh motives are crucial in supporting family (Harvey et al . ; Fielding & Duff ; Soliday et al . ; Pai & Ingerski ).…”

Section: Nutrition Counsellingmentioning

confidence: 99%

Dietary Adherence in Children With Chronic Kidney Disease: A Review of the Evidence

Apostolou

Karagiozoglou-Lampoudi

2014

Journal of Renal Care

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“…In addition, while no empirical evidence is presented, a case has been made for the clinical value of multidisciplinary treatment in the following areas: rheumatology (Ryan 1995); children on peritoneal dialysis (Harvey et al 1996); HIV/AIDS (Satterwhite et al 1991;Samet et al 1995); chronic wound care (Ratliff & Rodeheaver 1995); myofascial pain syndrome (Auleciems 1995); breast care (August et al 1993); cancer screening (Johnson et al 1993); and saliva control/drooling (Reddihough, Johnson & Ferguson 1992).…”

Section: Literature Reviewmentioning

confidence: 99%

“…The papers reviewed also highlight patient benefits which are not directly related to clinical outcomes. These included increased patient convenience (Haig et al 1994;Ratliff & Rodeheaver 1995); better rate of attendance at clinics (Banahan et al 1994), and better training of resident medical officers in both clinical management (Schipper & Dick 1995;Harvey et al 1996) and in communication skills (Weinsier et al 1991;Nielsen, Kiley & Rosa 1993).…”

Section: Literature Reviewmentioning

confidence: 99%

Problems in counting and paying for multidisciplinary outpatient clinics

Jackson

Sevil

1997

Aust. Health Review

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Policy-makers have always found it problematic to formulate fair and consistent counting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended and unintended consequences in the context of Victoria's introduction of output-based funding for outpatient services.

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The Team Approach to the Management of Children on Chronic Peritoneal Dialysis

Cited by 17 publications

References 36 publications

Racial Differences in Choice of Dialysis Modality for Children With End-stage Renal Disease

Racial Differences in Choice of Dialysis Modality for Children With End-stage Renal Disease

Dietary Adherence in Children With Chronic Kidney Disease: A Review of the Evidence

Problems in counting and paying for multidisciplinary outpatient clinics

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