[Hemodialysis performance in Center East Tunisia: Compliance and adequacy of biological tests (PHCET study 2014)]

Rev Epidemiol Sante Publique. 2019 Feb;67(1):33-41. doi: 10.1016/j.respe.2018.10.005. Epub 2018 Dec 13.
[Article in French]

Abstract

Background: Determining the performance level of hemodialysis facilities, including an evaluation of biological tests, is a prerequisite for quality assessment of these healthcare structures.

Objective: The purpose of this work was to evaluate the compliance and adequacy of biological tests performed in 2014 in Center-East Tunisia hemodialysis units.

Methods: Data were collected using an analysis grid for 15 biological indicators including 11 process items and four results items used to determine the compliance and adequacy rates respectively.

Results: This study included 660 hemodialysis patients (sex ratio 1.16; mean age 53.9±15.32 years). A low level of compliance was noted for several biological tests (blood glucose: 0.8%; hemoglobin 34.5%). The rate of adequacy of the biological results was insufficient, especially for anemia (32.7%) and calcium-phosphorus surveillance (41.8%). Intercenter and inter-region variability was noted, both for compliance and for adequacy of biological tests.

Conclusion: This study demonstrated low compliance of biological tests performed for hemodialysis patients and the non-adequacy of the results obtained. It is thus urgent to institute a quality management system for biological tests performed in hemodialysis units.

Keywords: Audit médical; Biological tests; Dialyse rénale; Examens biologiques; Healthcare quality; Hemodialysis; Hemodialysis units; Indicateurs qualité santé; Medical audit; Quality of care indicators; Qualité des soins de santé; Tunisia; Tunisie; Unités hospitalières d’hémodialyse.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Diagnostic Tests, Routine / standards*
  • Diagnostic Tests, Routine / statistics & numerical data
  • Female
  • Guideline Adherence / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data
  • Quality Indicators, Health Care / statistics & numerical data*
  • Quality of Health Care / statistics & numerical data*
  • Renal Dialysis / standards*
  • Renal Dialysis / statistics & numerical data
  • Tunisia