Groote Schuur Hospital Case Study

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4.0 Study Aims and Objectives

Broad objective
To assess the outcomes of patients presented to the renal replacement committee at Groote Schuur Hospital.
Specific objectives
1. To describe the socio demographic characteristics of patients presented
2. To describe the clinical characteristics of patients presented
3. To determine the factors associated with selection of patients onto the program
4. To compare the characteristics of patients selected before and after implementation of the current guidelines 5.0 Research Design and Methodology

5.1 Study Design.

This was a retrospective analytic study in which characteristics and outcomes of patients assessed by the renal replacement therapy (RRT) committee were recorded from the assessment
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Non-compliance any lack of adherence to appointments or medication.

7. Substance abuse. Use of any highly addictive substance excluding nicotine. In the case of alcohol, excessive use/dependency had to be demonstrated.

8. Hospital Care Cost. GSH classifies patients according to their ability to pay the hospital bills.[51]H0 are pensioners, those on grants and formally unemployed. H1 are those who earn up to 36,000 rands per annum. H2 those who earn 36,000-72,000 per annum. H3 above 72,000 rands per annum. Patients classified as Private were those charged full patient fees with no subsidized prices. Charged patients comprised H1,H2, and H3 patients. In this research protocol patients were classified as paying patients or non-paying patients

9. Socio economic status in the Cape Town area. The socioeconomic status of areas in Cape Town was mapped in 2001.[52] A socioeconomic status index was based on low income, low educational attainment, high unemployment levels and jobs in relatively unskilled occupations. Patients’ area codes were used to classify patients as either coming from an area with the worse 20% socioeconomic status index or not.
5.6 Data analysis and statistical
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Privacy and confidentiality of the subjects were protected. The patients’ identity was hidden by use of a code instead of names in the case record form. Furthermore the case record forms are stored in the investigators office. Data entered is password protected.

Informed consent will not be sought as this is a retrospective audit. And also lack of informed consent is justified by the fact that the investigators are part of the therapeutic team. The data are not accessed by a third party and hence not a breach of confidentiality. Furthermore, it is the obligation of the therapeutic team to ensure justice in the selection of patients into the renal replacement program is assured. Hence this audit represents the exception in the requirement of informed consent in retrospective studies as described by Junod and Elga.[54]

Finally this protocol has ethical approval from the Faculty of Health sciences, Human Research Ethics Committee of the University of Cape Town (HREC REF:

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