Healthcare models, quality indicators and quality of care in the management of patients with chronic kidney disease in Spain: Results from the CARABELA-CKD initiative

Abstract

Background and objectives

Chronic kidney disease (CKD) poses a significant public health challenge worldwide and its prevalence is rising due to aging populations and increasing risk factors. The CARABELA-CKD initiative aims to address CKD management inefficiencies.

Materials and methods

The CARABELA-CKD initiative was structured into four phases. The methodology involved five pilot center studies, conducted to characterize CKD healthcare models (Phase 1), followed by the validation of disease care models, improvement areas, potential solutions, and strategic healthcare quality indicators in a National Multidisciplinary Workshop (Phase 2). Regional meetings were then held to refine all these aspects from a regional perspective and to determine the cocreation of solutions with subsequent quantitative validation of results using the two-round Delphi method (Phase 3B). Dissemination and implementation included integrating findings into digital questionnaires creating digital Playbooks and organizing local workshops (Phase 4).

Results

The study identified three CKD care models in Spanish hospitals, each with distinct levels of specialization and resource availability. Twenty-five healthcare quality indicators were validated in a national meeting to assess various aspects of care quality and transformation. Improvement areas were identified, leading to the formulation of solutions to enhance CKD care models in Spain.

Conclusions

The CARABELA-CKD initiative, a collaborative effort between Scientific Societies involved in the CKD care process and AstraZeneca, is a nationwide attempt in Spain to create a framework to promote solutions in healthcare delivery and improvements in the quality of care that result in better health outcomes and higher standards of care quality, improved quality of life for patients, and increased efficiency of the Healthcare Service.