TY - JOUR T1 - Evidence on outsourcing dialysis services: a scoping review JO - Nefrología (English Edition) T2 - AU - Caro Martínez,Araceli AU - González Vera,María de los Ángeles AU - Prieto Velasco,Mario AU - Olry de Labry Lima,Antonio SN - 20132514 M3 - 10.1016/j.nefroe.2023.03.002 DO - 10.1016/j.nefroe.2023.03.002 UR - https://revistanefrologia.com/en-evidence-on-outsourcing-dialysis-services-articulo-S2013251423000500 AB - IntroductionChronic kidney disease represents an important health problem, due to its high incidence and prevalence, as well as its significant morbidity and mortality and socioeconomic cost. Aimscompare the effectiveness and economic consequences of outsourcing versus hospital dialysis. MethodA scoping review, for which different databases were consulted, using controlled and free terms. Those articles that compared concerted versus in hospital dialysis in terms of effectiveness were included. Likewise, those publications that compared, in the Spanish field, the cost between both modes of service provision and the public price rates of the different Autonomous Communities were included. Results11 articles were included in this review: 8 on comparison of effectiveness, all of them in the USA, and 3 on costs. A higher rate of hospitalization was observed in subsidized centers, but no differences in mortality were observed. Additionally, greater competition among providers was associated with lower hospitalization rates. The cost studies reviewed show that hospital hemodialysis is more expensive than in subsidized centers, due to the structural costs. The data of the public rates of the different Autonomous Communities show a wide heterogeneity in the payment of the concerts. Conclusionsthe coexistence in Spain of public and subsidized centers, the variability in the provision and costs of dialysis techniques, and the low of evidence on the effectiveness of outsourcing treatment show all the need to continue promoting strategies that result in improvement in the care for Chronic Kidney Disease. ER -