| Summary: | English only EURO HQ EUR/ICP/QCPH 01 02 03 42 p. As part of a joint quality development project between the WHO Regional Office for Europe and the renal societies of Denmark, Finland, Iceland, Norway and Sweden, representatives of the societies and WHO have developed a core data set for quality of care development in renal medicine. In April 1999, representatives of 18 renal centres in the five countries met to discuss the results of an evaluation of care based on the analysis of random samples of chronic renal patients collected from 1673 patients in the centres. In an anonymous comparison of selected indicators ("bench-marking") of participating centres, there was a marked difference between centres in indicators of referral/acceptance patterns and diagnostic activity. Despite a significant improvement in blood pressure from time of first referral to follow-up, under half the patients had blood pressure below 140/90 at follow-up, the proportion varying twofold between centres. Analysis of the application of common renal therapeutic principles showed a marked variation across the centres, sug-gesting that guidelines may have little effect on clinical nephrological practice. Participants concluded that the demon-strable differences between centres were unwanted, unnecessary and possibly inequitable, and recommended that: nephrologists should assume a greater responsibility in the organization of early renal care from a secondary and tertiary prevention perspective to reduce morbidity and cost; anonymous comparison of selected indicators with feedback to centres may be a feasible method for reducing differences in quality of treatment and care for persons with renal disease; the NEPHROCARE data set is a feasible tool for quality of care development in all kinds of renal treatment and care; information on renal patients is particularly complex and should be made more easily accessible to nephrologists through the use of compatible electronic patient records incorporating the NEPHROCARE data set; the NEPHROCARE project should continue
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