[Effects of the implementation of Universal Access with Explicit Guaranties (AUGE) Plan on the quality of care of patients with terminal renal failure].
BACKGROUND
The implementation of the AUGE plan for renal failure in Chile in August 2002, generated larger waiting list for outpatient care.


OBJECTIVE
To analyze the incidence of terminal renal failure, the proportion of patients that were admitted to hemodialysis using a definitive vascular access and the lapse of use of transitory catheters, before and after the implementation of AUGE in Calama.


METHODS
Since 1999, in a dialysis center of Calama, all new patients that are admitted to hemodialysis and the type of vascular access they have are registered. Using this registry, the incidence of terminal renal failure and the lapse between the admission to the center and the installation of a definitive vascular access were calculated for the period 2000 to 2005.


RESULTS
From January 2000 to December 2003, the incidence of terminal renal failure was stable in 190 +/- 21 patients per million inhabitants (ppmh). It decreased between January and September 2004 to 124 +/- 18.6. Afterwards, it progressively increased to 221 +/- 21 ppmh. In the study period, the proportion of patients admitted to hemodialysis with a definitive access decreased from 63 to 10% (p<0.01) and the mean lapse of transitory catheter use, increased from 32.9 +/- 42.6 to 73.1 +/- 80.4 days (p<0.01).


CONCLUSIONS
The implementation of AUGE for chronic renal failure reduced the quality of care of patients admitted to hemodialysis.
González
Fernando
F
Sección de Nefrología, Departamento de Medicina Oriente, Facultad de Medicina, Universidad de Chile. fgonzalf@puc.cl
D000704:Analysis of Variance; D002408:Catheters, Indwelling / Q000706:statistics & numerical data; D002677:Chile / Q000453:epidemiology; D006284:Health Plan Implementation / Q000458:organization & administration / Q000592:standards*; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010343:Patient Admission; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D006435:Renal Dialysis; D013727:Terminal Care / Q000458:organization & administration / Q000592:standards*; D013997:Time Factors; D014850:Waiting Lists