By: Ed Susman
LAS VEGAS, NV - Patient care at dialysis clinics appears to be like in urban and suburban areas, according to a theme at the National Kidney Foundation Spring Clinical Meetings.
The median score on the DaVita Quality Index for 63 inner-city clinics was 68.37 compared with a mark of 67.35 for 1,298 suburban clinics (P=0.
5), said Rich Mutell, MBA, director of health economics and informatics for DaVita Clinical Research, based in Minneapolis.
The DaVita Quality Index is a proprietary benchmarking tool that ranks an individual dialysis clinic`s performance against company-wide results on a 100-point scale. Mutell reviewed the data culled form the national DaVita database of 100,000 people being treated for end-stage renal disease.
For this retrospective analysis, the researchers looked at whether patients in both groups had received proper vaccinations, if their anemia was under control, and how many had admission to a type of dialysis that minimizes the chance of infections.
They also noted how efficient dialysis was in removing toxins from patients` bodies and the part of patients with healthy blood levels of parathyroid hormone, calcium, phosphorus, and albumin. Data for the inner-city clinics included 7,530 patients; data from the suburban clinics included 100,386 patients.
Among the outcomes, only albumin score appeared to differ significantly, with higher scores among the inner-city patients: An average 6.40 on the DaVita Quality Index for albumin compared with 5.91 among the patients in the suburban clinics (P
A dialysis facility had to play two criteria in rank to be classified as inner- city: More than 20% of the households lived under the poverty line based on U.S. postal zip codes and a population density of over 10,000 people per square mile.
"These results show no differences in patient outcomes between inner-city and non-inner city units," Mutell said.
Mutell said this subject was undertaken because of other reports suggesting that the character of dialysis care for urban patients living in poverty was below national standards. He pointed out that the fault in those studies was the use of "one quality measures rather than a comprehensive suite of metrics."
"It is not so surprising to me that there were not huge differences in outcomes," commented Jeffrey Berns, MD, associate head of renal, electrolyte, and hypertension division of the Perelman Center for Advanced Medicine at the University of Pennsylvania in Philadelphia.
"A lot of the charge provided in a dialysis clinic is protocolized and that [protocol] would get applied similarly, whether in a suburban facility or an urban one," Berns said.
While the presumed disadvantage between urban and suburban dialysis clinics may be questionable, Mutell noted that inner-city clinics could be perceived to allow better care because patients have easier access, either through proximity to the clinic or better transportation options.
- MFP Wire Services
- 05-04-2011
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