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BACKGROUND/RATIONALE:
BACKGROUND/RATIONALE:
Chronic kidney disease (CKD) is a growing public health concern because it is a highly prevalent condition affecting more than 20 million Americans including veterans. It is associated with poor outcomes and increased health care costs. In spite of significant advances in the diagnosis and treatment of most chronic diseases, there is evidence that racial and ethnic minorities tend to receive suboptimal care than non-minorities and that patients of minority ethnicity experience greater morbidity and mortality from various chronic diseases than non-minorities. However, little is known about racial/ethnic disparities in CKD care, and effect of quality of CKD care on treatment cost among veterans with CKD.
OBJECTIVE(S):
OBJECTIVE(S):
The overall goals of this study are to determine racial/ethnic variations in receipt of guideline concordant care and examine the effect of guideline concordant care for CKD on treatment cost. The specific aims of the proposed project are as follows:
Specific Aim 1: To determine racial/ethnic differences in receipt of optimal care for CKD within 12 months from the date of initial CKD diagnosis as defined by the K/DOQI and VHA-DoD clinical practice guideline for CKD.
Specific Aim 2: To examine impact of provision of overall recommended care for patients with CKD within 12 months from the date of initial CKD diagnosis on treatment cost in Veterans with CKD.
METHODS:
METHODS:
To address these specific aims, we will propose a retrospective cohort analysis with two phases. In the first phase (baseline), we will identify incident patients with CKD linked with VIReC/Medicare data. The characteristics of these incident cases and treatment patterns within the first 12 months after the initial diagnosis of CKD will be examined. In the second phase (follow-up), the subjects will be followed from the date of their index glomerular filtration rate (GFR) to death, or until September 30, 2005. Descriptive and multivariate regression methods will be used in the proposed study.
FINDINGS/RESULTS:
Enter text here.
IMPACT:
IMPACT:
The anticipated results of the proposed study are expected to provide important information to VA decision makers, clinical providers, and researchers in understanding racial disparities in receipt of quality of CKD care and cost of CKD treatment. We also believe the information on the initial care pattern can be used to improve clinical care for veterans with CKD.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases, Health Services and Systems
DRE:
Quality of Care, Treatment
Keywords:
Clinical practice guidelines, Cost, Minority
MeSH Terms:
none
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