Healthcare models, quality indicators and quality of care in the management of patients with chronic kidney disease in Spain: Results from the CARABELA-CKD initiative

• Published in: Nefrología 2024-11
• Main Authors: Salgueira, Mercedes, Ruiz, Pedro, Diago, Jesús Ignacio, Pérez Maraver, Manuel
• Format: Article
• Language: English
• Subjects: Calidad asistencial; Chronic kidney disease; Enfermedad renal crónica; Healthcare models; Indicadores; Indicators; Management; Manejo; Modelos asistenciales; Quality of care
• ISSN: 0211-6995
• DOI: 10.1016/j.nefro.2024.11.001

Chronic kidney disease (CKD) poses a significant public health challenge worldwide and its prevalence is rising due to aging populations and increasing risk factors. The CARABELA-CKD initiative aims to address CKD management inefficiencies. The CARABELA-CKD initiative was structured into four phases. The methodology involved five pilot center studies, conducted to characterize CKD healthcare models (Phase 1), followed by the validation of disease care models, improvement areas, potential solutions, and strategic healthcare quality indicators in a National Multidisciplinary Workshop (Phase 2). Regional meetings were then held to refine all these aspects from a regional perspective and to determine the cocreation of solutions with subsequent quantitative validation of results using the two-round Delphi method (Phase 3B). Dissemination and implementation included integrating findings into digital questionnaires creating digital Playbooks and organizing local workshops (Phase 4). The study identified three CKD care models in Spanish hospitals, each with distinct levels of specialization and resource availability. Twenty-five healthcare quality indicators were validated in a national meeting to assess various aspects of care quality and transformation. Improvement areas were identified, leading to the formulation of solutions to enhance CKD care models in Spain. The CARABELA-CKD initiative, a collaborative effort between Scientific Societies involved in the CKD care process and AstraZeneca, is a nationwide attempt in Spain to create a framework to promote solutions in healthcare delivery and improvements in the quality of care that result in better health outcomes and higher standards of care quality, improved quality of life for patients, and increased efficiency of the Healthcare Service. La enfermedad renal crónica (ERC) representa un desafío significativo para la salud pública a nivel mundial. Su prevalencia está en aumento debido al envejecimiento poblacional y a factores de riesgo crecientes. La iniciativa CARABELA-CKD busca abordar las ineficiencias en el manejo de la ERC. La iniciativa CARABELA-CKD se estructuró en 4 fases. En la primera fase, se caracterizaron los modelos de atención de la ERC en 5 centros piloto. En una segunda fase en una reunión nacional se validaron estos modelos, las áreas de mejora y las soluciones potenciales, además de indicadores de calidad en el manejo de la ERC. En la tercera fase se procedió a realizar reuniones regionales