Do more visits with kidney specialists improve dialysis patient-reported outcomes?


In a recent analysis, more frequent kidney specialists’ visits to clinics where patients with kidney failure undergo outpatient hemodialysis were not associated with more favorable patient-reported experiences with care. In fact, more frequent visits were associated with slightly lower patient-reported experiences. The findings will appear in an upcoming issue of CJASN.

Previous research has examined whether patients with kidney failure gain health benefits from more frequent visits with kidney specialists, with mixed findings about the potential benefits of more frequent visits regarding mortality, transplantation, hospitalizations, and other outcomes. In this new study, a team led by Kevin Erickson, MD, MS (Baylor College of Medicine) focused on patients-reported experience of care and assessed whether patients who receive more face-to-face dialysis visits from their physician are more satisfied with their kidney-related care.

The investigators linked patient records from a national kidney failure registry to patient experience data from the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) survey. Among 243,324 patients who received care in 2015 at more than 5,000 U.S. dialysis facilities, 71% had 4 or more face-to-face visits per month with kidney specialists, 17% had 2 to 3 visits, 4% had 1 visit, and 8% had no visits.

Each 10% absolute higher proportion of patients seen by a kidney specialist 4 or more times per month was associated with a modestly but statistically significant lower score of patient experience with kidney-related care.

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