Abstract: SA-PO202
Will the Nephrologist See You Now? Results from the ASN/ERA-EDTA/ISN Global Nephrology Workforce Survey
Session Information
- Educational Research
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Pivert, Kurtis, American Society of Nephrology, Washington, District of Columbia, United States
- Sozio, Stephen M., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Caskey, Fergus J., University of Bristol, Bristol, United Kingdom
- Levin, Adeera, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
Background
In low- and middle-income countries, concerns exist about nephrology workforce adequacy to meet population needs; and in high-income regions, concerns exist about declining interest in nephrology among trainees. ASN, ERA-EDTA, and ISN initiated a joint project to determine how kidney care delivery trends may affect future workforce demands by quantifying variation in nephrology scope of practice at the country- and region-specific level.
Methods
A survey was designed to capture national kidney health delivery measures, including nephrology training/certification and scope of practice; number of nephrologists/country; and range of kidney care provided by nephrologists, other physicians, and extenders. Given the global audience, the tool was translated and adapted to several formats before being distributed to leaders of national nephrology or medical societies in 167 countries.
Results
Sixty-eight countries (41%) have responded. There was little variation between regions in the scope of nephrology practice, with nephrologists the primary physicians for most key kidney health services/therapeutic areas (Fig 1 left). Yet ~50% noted nephrologists were not the primary physician for CKD stages 1–3 and hypertension. Nephrologists commonly prescribe biopsies (98%) yet are less likely to perform them (71%) (Fig 1 right). Stratified by region, Europe demonstrated the most intra- and interregional variability in scope of practice (e.g., 42% of European respondents reported nephrologists were primarily responsible for CRRT vs. 64% globally). A majority (60%) required nephrologists to be present in the dialysis facility, and many nephrologists rounded each dialysis session (hospitals, 50%; other facilities, 41%).
Conclusion
The Global Nephrology Workforce Survey found less interregional, but substantial intraregional, variation in the scope of kidney health services provided by nephrologists. A complete analysis of kidney health delivery trends will be translated to help assess nephrology workforce demands and inform regional efforts to ensure patients receive consistent, high-quality care.
Fig 1