TY - JOUR T1 - The contribution of outpatient nephrology to the control of demand: Analysis of the comprehensive Health Area of Barcelona Esquerra (AISBE) JO - Nefrología (English Edition) T2 - AU - Arrizabalaga,Pilar AU - Gómez,Mónica AU - Menacho,Ignacio AU - Pallisa,Lidia AU - Jorge,Vanesa AU - Poch,Esteban SN - 20132514 M3 - 10.1016/j.nefroe.2019.03.005 DO - 10.1016/j.nefroe.2019.03.005 UR - https://revistanefrologia.com/en-the-contribution-outpatient-nephrology-control-articulo-S2013251419300549 AB - The coordination between nephrology and primary care is well documented in the management of chronic kidney disease (CKD), but the real impact is uncertain. ObjectiveTo evaluate the efficiency of an outpatient nephrology programme (ONP) implanted progressively over the course of 10 years regarding the demand for CKD care in the Integral Health Area of Barcelona Esquerra, accounting for 524,395 inhabitants, which is more than a third of the population of Barcelona. Material and methodsThe number and age of the new referrals to nephrology between 2004 and 2014 were identified and a referral index (RI) was established between the number of new referrals and the estimated prevalence of CKD in the population treated, based on the implementation of the ONP. ResultsThe adult population decreased between 2006 and 2014, but the number of inhabitants aged 65 years or above increased from 107,025 to 113,461 and so did the estimated CKD. Renal insufficiency was the reason for more than 70% of the referrals made to nephrology. The average age was 74 years old between 2004 and 2009 and 70 between 2010 and 2014. The RI showed two trends in the analysed period, depending on whether or not the ONP included the face-to-face consultancy. ConclusionsThe decrease in RI suggests a better resolution at primary care. The major improvement in the Basic Health Areas of reference (with RI reduced by more than 44%) coincides with the implementation of the ONP. The implantation of ONP overcome the gap between primary and hospital care in order to respond to chronicity, ageing and dependence. ER -