Ability to Work as a Function of Quality of Care

• In Event: 158 - Section on Disability and Society Roundtable Session (one-hour).
  In Refereed Roundtable: Section on Disability and Society Roundtables (one-hour). Table 01

Abstract

An association has been shown between incremental achievement of hemodialysis (HD) quality indicator (QI) goals and patient morbidity and quality of life, but whether patient-assessed ability to work varies as a function of QI goals is unknown. In a multi-center study, 509 chronic HD patients aged 18-64 responded to the interview question “Are you now able to work for pay (full-time or part-time)?” Likelihood of reported ability to work by achievement of QI goals was examined in logistic regression models adjusted for age, sex, race, educational level, diabetes, congestive heart failure, depressive symptomatology (CES-D score), vintage, and facility clustering. The mean (S.D.) number of HD QI goals met was 3.31 (1.07); median = 3.0. With number of QI goals met (0-5) as a continuous variable, patients’ likelihood of reporting ability to work increased with an increasing number of QI goals met (OR 1.28 [95% CI 1.04-1.57]; p = 0.02). Age less than 55 and lower CES-D score were additional independent predictors of reported ability to work. Substitution of employment for perceived ability to work gave similar results. Ability to work is a concept that cannot be directly measured, and self-reported ability to work and employment status both constitute indirect measures of this construct. However, these data suggest an important link between meeting HD QI goals and vocational rehabilitation potential in this "disabled" population.

Author

• Nancy G. Kutner, Emory University