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

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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 gain health benefits from more frequent visits with 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 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.

"Findings from this study provide evidence that more isn't always better in dialysis, and that patients at facilities where physicians provide more face-to-face dialysis visits do not report better experiences with their nephrology care," said Dr. Erickson. "The finding that more frequent face-to-face are not associated with better patient-reported experiences suggests an opportunity for nephrologists to improve the care they deliver by focusing more of their time and effort towards activities that patients benefit from rather than focusing on seeing all 4 times per month."

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More information: Brian M. Brady et al, Patient-Reported Experiences with Dialysis Care and Provider Visit Frequency, Clinical Journal of the American Society of Nephrology (2021). DOI: 10.2215/CJN.16621020
Citation: Do more visits with kidney specialists improve dialysis patient-reported outcomes? (2021, July 13) retrieved 17 September 2021 from
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