ArticleBMC nephrology2022
Referral criteria for chronic kidney disease: implications for disease management and healthcare expenditure-analysis of a population-based sample.
Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical and Financial Impacts of Late Referral in Patients With Chronic Kidney Disease: A Narrative Review.Cureus · 2025Review
- Shaping the Future of Chronic Kidney Disease Management in Spain: Insights from the CARABELA-CKD Initiative.Journal of clinical medicine · 2025Article
- Criteria-based outpatient scheduling at a nephrology clinic: prospective evaluation of patient pre-assessment and its corresponding adaptive scheduling strategy.BMC health services research · 2024Article
- Guidelines or mindlines? - implementing a new CKD guideline in German primary care.BMC primary care · 2024Article
- Framework of Guidelines for Management of CKD in Asia.Kidney international reports · 2024Article
- [Development of quality indicators for the care of patients with chronic kidney disease : Results of a structured consensus process using the Delphi technique].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
- Multi-Center Health Informatics to Examine the Implementation of Guideline-Directed Medical Therapy in Chronic Kidney Disease.Journal of primary care & community healthArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical practice guidelines recommend specialist referral according to different criteria. The aim was to assess recommended and observed referral rate and health care expenditure according to recommendations from: • Kidney Disease Improving Global Outcomes (KDIGO,2012) • National Institute for Health and Care Excellence (NICE,2014) • German Society of Nephrology/German Society of Internal Medicine (DGfN/DGIM,2015) • German College of General Practitioners and Family Physicians (DEGAM,2019) • Kidney failure risk equation (NICE,2021)
methodsData of the population-based cohort Study of Health in Pomerania were matched with claims data. Proportion of subjects meeting referral criteria and corresponding health care expenditures were calculated and projected to the population of Mecklenburg-Vorpommern.
resultsData from 1927 subjects were analysed. Overall proportion of subjects meeting referral criteria ranged from 4.9% (DEGAM) to 8.3% (DGfN/DGIM). The majority of patients eligible for referral were ≥ 60 years. In subjects older than 60 years, differences were even more pronounced, and rates ranged from 9.7% (DEGAM) to 16.5% (DGfN/DGIM). Estimated population level costs varied between €1,432,440 (DEGAM) and €2,386,186 (DGfN/DGIM). From 190 patients with eGFR < 60 ml/min, 15 had a risk of end stage renal disease > 5% within the next 5 years.
conclusionsApplying different referral criteria results in different referral rates and costs. Referral rates exceed actually observed consultation rates. Criteria need to be evaluated in terms of available workforce, resources and regarding over- and underutilization of nephrology services.
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