Tuesday, December 31, 2013

IN the NEWS: Profit or non for profit dialysis units and USRDS data study

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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