Patient-related dialysis facility closures

Strong points

  • Patients with renal failure who were affected by the closure of dialysis facilities between 2001 and 2014 experienced hospitalization rates 7 to 9% higher than similar patients in facilities that did not close. .
  • Additionally, patients affected by the closures may have faced an 8% higher risk of death within 6 months.

Washington, DC (October 4, 2021) – Some experts are concerned that recent reforms by the Centers for Medicare and Medicaid Services may result in the closure of some dialysis facilities that treat patients with kidney failure. When investigators analyzed data from previous dialysis facility closures, they found that patients affected by the closures had higher hospitalization rates. The results, which will appear in a future issue of JASN, stress the need for policies that reduce the risk of shutdown of dialysis facilities to help protect patient health.

More than 500,000 patients in the United States receive dialysis for the treatment of kidney failure at 7,100 dialysis centers. When a dialysis facility closes, a patient may find it difficult to travel to a new facility or may temporarily receive suboptimal care as staff at a new facility establish a relationship with the patient and overcome common challenges. that occur during dialysis treatments.

A team led by Kevin Erickson, MD, MS (Baylor College of Medicine) looked at dialysis facility closures between 2001 and 2014 to assess the effects of the closures on patient health outcomes. Researchers identified 8,386 patients affected by 521 dialysis facility closures. In different models, patients who were affected by the closure of dialysis facilities experienced hospitalization rates 7-9% higher than similar patients in facilities that did not close. Additionally, patients affected by the closures may have faced an 8% higher risk of death within 6 months.

“Ongoing efforts to contain the high costs of center hemodialysis, including recent national policy reforms, could increase the risk of some dialysis centers being closed. It is important to understand the impact of dialysis facility closures on patient health, ”said Dr. Erickson. “We have previously demonstrated that hospital-based dialysis facilities, which disproportionately support vulnerable patient populations, are at increased risk of shutdown. Facility closures could exacerbate inequalities in dialysis care in the United States.

Study co-authors include Jingbo Niu MD, DSc, Maryam Saeed, MD, and Wolfgang Winkelmayer MD, ScD.

Disclosures: Dr. Erickson provides consulting services to Acumen LLC.

The article, titled “Patient health outcomes after dialysis facilities in the United States close,” is available at https://jasn.asnjournals.org/content/32/10/2613.

The contents of this article do not reflect the views or opinions of the American Society of Nephrology (ASN). Responsibility for the information and opinions expressed herein lies entirely with the authors. ASN does not offer medical advice. All the content of ASN publications is provided for informational purposes only and is not intended to cover all the uses, directions, precautions, drug interactions or possible adverse effects. This content should not be used in a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about any medical condition or before taking any medication, changing your diet, or starting or stopping any treatment. Do not ignore or delay obtaining professional medical advice because of the information accessible via ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has led the fight to prevent, treat and cure kidney disease across the world by training healthcare professionals and scientists, advancing research and innovation, communicating new knowledge and advocating for the highest quality patient care. ASN has more than 21,000 members representing 131 countries. For more information visit www.asn-online.org.

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