Dialysis-network variability in home dialysis use not explained by patient characteristics: a national registry-based cohort study in France - Archive ouverte HAL Access content directly
Journal Articles Nephrology Dialysis Transplantation Year : 2022

Dialysis-network variability in home dialysis use not explained by patient characteristics: a national registry-based cohort study in France

Cécile Couchoud
Clémence Béchade
Anne Kolko
  • Function : Author
Agnès Caillette Baudoin
  • Function : Author
Florian Bayer
  • Function : Author
René Ecochard
Thierry Lobbedez

Abstract

ABSTRACT Background Although associated with better quality of life and potential economic advantages, home dialysis use varies greatly internationally and appears to be underused in many countries. This study aimed to estimate the dialysis-network variability in home dialysis use and identify factors associated with (i) the uptake in home dialysis, (ii) the proportion of time spent on home dialysis and (iii) home dialysis survival (patient and technique). Methods All adults ≥18 years old who had dialysis treatment during 2017–2019 in mainland France were included. Mixed-effects regression models were built to explore factors including patient or residence characteristics and dialysis network associated with variation in home dialysis use. Results During 2017–2019, 7728/78 757 (9.8%) patients underwent dialysis at least once at home for a total of 120 594/1 508 000 (8%) months. The heterogeneity at the dialysis-network level and to a lesser extent the regional level regarding home dialysis uptake or total time spent was marginally explained by patient characteristics or residence and dialysis-network factors. Between-network heterogeneity was less for patient and technique survival. These results were similar when the analysis was restricted to home peritoneal dialysis or home hemodialysis. Conclusions Variability between networks in the use of home dialysis was not fully explained by non-modifiable patient and residence characteristics. Our results suggest that to increase home dialysis use in France, one should focus on home dialysis uptake rather than survival. Financial incentives and a quality improvement programme should be implemented at the dialysis-network level to increase home dialysis use.
No file

Dates and versions

hal-04176578 , version 1 (03-08-2023)

Identifiers

Cite

Cécile Couchoud, Clémence Béchade, Anne Kolko, Agnès Caillette Baudoin, Florian Bayer, et al.. Dialysis-network variability in home dialysis use not explained by patient characteristics: a national registry-based cohort study in France. Nephrology Dialysis Transplantation, 2022, 37 (10), pp.1962-1973. ⟨10.1093/ndt/gfac055⟩. ⟨hal-04176578⟩

Collections

HCL
4 View
0 Download

Altmetric

Share

Gmail Facebook X LinkedIn More