Quality of healthcare for hemodialysis patients in various health sectors in Jeddah, Saudi Arabia

Abstract

BACKGROUND AND OBJECTIVE: We compared the adequacy of the management of hemodialysis patients in different health sectors in a major city in Saudi Arabia. DESIGN AND SETTING: Cross-sectional analytic study conducted in three different health sectors in Jeddah, Saudi Arabia. METHODS: Data was collected from nine hemodialysis centers, which represent three sectors: Ministry of Health, governmental (but not health ministry) hospitals, and charity centers. A simple random sampling technique was employed for gathering data from the participating centers. Medical records were reviewed and all the relevant data were retrieved using a pre-designed form. RESULTS: In the 587 subjects, hypertension, diabetes mellitus and an idiopathic etiology accounted for 85.3% of end-stage renal disease. Only 25.4% of the patients had a hemoglobin level of 110-120 g/L and 12.1% achieved target levels of ferritin and transferrin saturation. The percentage of patients meeting targeted levels of calcium (2.1-2.38 mmol/L), phosphorous (1.13-1.78 mmol/L) and albumin (≥40 g/L) were 54.2%, 38.7% and 23.5%, respectively. The variation between different health sectors was statistically significant (P<.001). Arteriovenous fistula was used for 84% of the patients and catheter for 15.7%. CONCLUSION: The quality of healthcare for hemodialysis patients in Jeddah needs improvement to meet the recommendations of the Kidney Disease Outcomes Quality Initiative guidelines.