Advancing in the management of chronic kidney disease: the results of implementing a quick resolution consultation

Nefrologia. 2013 Jan 18;33(1):93-8. doi: 10.3265/Nefrologia.pre2012.Oct.11560.
[Article in English, Spanish]

Abstract

Background: Currently, chronic kidney disease (CKD) is understood as global important public health problem, a situation that requires a new approach.

Objectives: To show the results obtained after implementing a quick resolution consultation for CKD management.

Methods: Results were analysed during 6 month time period.

Results: A total of 9.61% of received proposals were referred to primary care without in-person visits. In addition, 28.05% of patients were initially evaluated through high resolution clinics and 62.33% were directly referred to other clinics. From the initial 28.05% mentioned, once evaluated, treatment adjusted and informed about the disease, 70% were referred over to primary care for monitoring and the remaining 30% were given specialist appointments. As a consequence, 70.65% of patients were selected for monitoring by nephrology from all proposals received, and 29.35% for primary care monitoring. We observed a significant decrease in the delay until the first medical appointment.

Conclusions: Quick resolution consultations demonstrated to be an efficient tool for CKD management. Its implementation allowed both low consumption of health care resources, selected patients with high risk of progressive cardiovascular disease for long term monitoring, and offered not only an initial evaluation and adjustment of treatment with information provided to those who would be monitored by primary care, but also diminished primary care delays significantly.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Interdisciplinary Communication
  • Nephrology
  • Primary Health Care
  • Referral and Consultation*
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / therapy*
  • Retrospective Studies
  • Time Factors