Being in dialysis unit that
is for profit vs hospital owned or non-for profit- does it matter? Both units
provide services that should be beneficial for the patients. A
recent study in CJASN 2013 looked at this specific question using USRDS
retrospective data on hospitalization and other outcomes between profit vs non
for profit units.
Some key summary points of their evaluation
Patients receiving
hemodialysis in for-profit facilities had a 15% higher relative rate of
hospitalization compared with those in non-profit facilities.
Among patients receiving
peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit
facilities was not significantly different
Patients on hemodialysis
receiving care in for-profit dialysis facilities had a 37% higher rate of
hospitalization for heart failure or volume overload and a 15% higher rate of
hospitalization for vascular access complications.
This is
one of the few studies to ever look into this difference. A prior study ( also
USRDS study) had looked into length of hospitalizations as well and had found
longer stays for profit facility patients. What could be the reasons for the
above findings:- training, fellow presence, staffing, medication protocols,
checks and balances, length of treatment, patient selection. Etc.
Keeping in mind this is a retrospective outcomes study, one must be cautious in looking at these results. Nephrology community should take necessary steps to try to provide equal care at the both type of dialysis centers.
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