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Healthcare 2017, 5(3), 42;

Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics

Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Author to whom correspondence should be addressed.
Academic Editors: Joanne Reid and Helen Noble
Received: 16 June 2017 / Revised: 28 July 2017 / Accepted: 2 August 2017 / Published: 7 August 2017
(This article belongs to the Special Issue The Socio-Economic Impact of End Stage Kidney Disease)
Full-Text   |   PDF [199 KB, uploaded 7 August 2017]


Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression—an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients’ top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes. View Full-Text
Keywords: ability to work; dialysis; employment; end-stage kidney disease; quality indicators; quality of care ability to work; dialysis; employment; end-stage kidney disease; quality indicators; quality of care
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Kutner, N.G.; Zhang, R. Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics. Healthcare 2017, 5, 42.

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