Abstract: Objective  To explore the effects of goal-directed model on improving quality of hemodialysis at grassroots level.  Methods  Patients receiving maintenance hemodialysis treatment at the Southern Branch of The First Affiliated Hospital of Zhengzhou University from October 2021 to March 2022 were enrolled in this study. After 6 months of goal-directed management, the improvement of vascular access, clinical indicators, quality of life, and health economics indicators of the patients were evaluated.  Results  A total of 85 cases were included. After 6 months of goal-directed management, proportion of the patients using tunneled-cuffed catheters decreased from 42.35% to 27.06% (χ2=6.303, P=0.043), proportion of the patients with a single-pool Kt/V ＜1.2 decreased to 7.05% (χ2=21.182, P＜0.001), and proportion of the patients with interdialytic weight gain ＜5% of dry weight increased to 70.59% (χ2=43.895, P＜0.001), as compared to the baseline data. The levels of hemoglobin (χ2=15.824, P=0.001), potassium (χ2=4.541, P=0.033), albumin (χ2=31.224, P＜0.001), phosphorus (χ2=17.306, P＜0.001) and intact parathyroid hormone (χ2=17.162, P＜0.001) improved significantly. Satisfaction of the patients increased from 48.24% to 100% (χ2=59.365, P＜0.001), and the quality of life score improved significantly (t=-22.455, P＜0.001). The total direct medical expenses did not increase significantly compared to the baseline (t=1.387, P=0.167).  Conclusion The goal-directed model effectively improves the quality of hemodialysis for grassroots patients, facilitates the management of complications and enhances the quality of life, but does not incur additional medical expenses, which demonstrate its stronger practical value.

Key words: Goal-directed model, Maintenance hemodialysis, Grassroot level, Medical cost