The prevalence of chronic kidney disease (CKD) is on the rise due to population aging and multimorbidity. Taiwan is particularly afflicted by this prevailing ailment. Although multidisciplinary pre-dialysis care has been implemented to halt CKD progression and reduce healthcare utilization in Taiwan, more is needed to reduce the local burden of CKD.
The Taiwan Joint Commission initiated a kidney-care disease-specific care (DSC) certification program since 2017, aiming to improve participating hospitals’ quality of care for kidney disease and to synchronize the quality of kidney care across Taiwan. We analyzed the trend of changes over time among kidney DSC certification program participating institutes during the period before, during, and after DSC certification program implementation, using the Generalized Estimating Equation methods.
A total of 20 institutes participated in the DSC certification program focusing on kidney diseases between January 2018 and March 2020, among which 70% were medical centers. DSC certification program was shown to significantly reduce the annual incidence of arteriovenous fistula reconstruction while increase the levels of serum albumin and hemoglobin among patients with end-stage renal disease (ESRD) under hemodialysis over time. For parameters related to peritoneal dialysis (PD), participating in the DSC certification program significantly increased serum albumin levels among patients with ESRD over time.
In this study, we discovered that a kidney-specific DSC certification program significantly improved multiple performance indicators of participating institutes including hemoglobin, albumin, and shunt recreation probability among patients undergoing hemodialysis.

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