Estimation of Physical Functional Disabilities and Long-term Care Needs for Patients Under Maintenance Hemodialysis

Bibliographic Data

ID9101934
AuthorsMei-Chuan Hung (0000-0002-2287-2403, National Cheng Kung University Hospital, corresponding author), Junne-Ming Sung, Junne‐Ming Sung (0000-0003-1916-7815, National Cheng Kung University Hospital, corresponding author), Yu-Tzu Chang (0000-0002-7487-6756), Yu‐Tzu Chang (0000-0003-1449-9431, National Cheng Kung University Hospital), Jing-Shiang Hwang (0000-0002-5807-7583, Institute of Statistical Science, Academia Sinica), Jung-Der Wang, Jung‐der Wang (0000-0002-3176-4500, National Cheng Kung University Hospital, corresponding author)
Year2014
Volume52
Issue1
Pages63-70
Publication date2014-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000010
PMID24300025
PMCIDPMC3868019
OpenAlexW1998772488
LanguageEN
Citations received2
References cited13

BACKGROUND AND OBJECTIVES: Physical functional disabilities in hemodialysis (HD) patients may increase their mortality and long-term care needs. The aim of this study was to estimate the changes of proportion for different physical functional disabilities along time after beginning HD and the lifelong care needs. METHODS: We used a population-based cohort consisting of 84,657 incident HD patients in Taiwan between 1998 and 2009 to estimate the survival function and extrapolate to lifetime through a semiparametric method. The Barthel Index (BI) was used to measure the functional disability levels cross-sectionally in 1334 HD patients recruited from 9 HD centers. A BI score <50 was considered as severe disability. Lifetime care needs were obtained by extrapolating the age-stratified survival functions to lifetime and then multiplying them with proportions of different kinds of functional disabilities over time. RESULTS: On average, HD patients had at least 6.4, 2.0, and 1.3 years without disability, with moderate disability, and severe disability, respectively. The most common care needs were stair-climbing and bathing, which were 3.0 and 1.7 years, respectively. HD patients were expected to have about 3 years living with disabilities for those beginning HD at an age above 35 years; however, the older the patient, the higher the proportion of functional disabilities and care needs. CONCLUSIONS: HD patients are in need of long-term care and require early intervention and resource planning. The method developed in this study can also be applied to other chronic illnesses with various functional disabilities

Estimation · Hemodialysis · Intensive care medicine · Long-term care · MEDLINE · Psychiatry · Term (time) · Dialysis and Renal Disease Management · Engineering · Frailty in Older Adults · Medicine · Nursing · Stroke Rehabilitation and Recovery

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