Abstract: TH-PO812

Association of Hemodialysis Quality Measures with Patients Dialysis Facility Rating

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Author

  • Ashkar, Ziad Maurice, None, Lafayette, Louisiana, United States
Background

The ICH-CAHPS In-Center Hemodialysis Survey is designed to measure the experiences of people receiving in-center hemodialysis care. Studies of Hospital HCAHPS have shown a significant positive associations between quality measures and patient satisfaction scores . Non profit hospitals and smaller hospitals also scored more favorably.The purpose of this study is to look into the association ICH-CAHPS global patient dialysis facility rating (GDR) with dialysis quality measures .

Methods

An observational retrospective, cross-sectional design. Data are obtained and matched from CMS Dialysis Facility Compare ,release date April 2017. From ICH CAHPS, percent of patients who gave their dialysis facility a rating of 9 or 10 over 10 are divided into deciles and used as outcome variables. Ordinal logistic regression with cluster by state is then done with averages of % hemodialysis patients with hemoglobin < 10 g/dl , % KT/V>= 1.2, % with AV Fistula use, % with catheters more than 90 days, phosphorus < 3.5 mg/dl and > 7mg/dl, average mortality rate, readmission rate,hospitalization rate, standardized infection ratio, number of dialysis stations, for-profit status, and chain ownership.

Results

For each unit increase in number of dialysis stations, there was 3% decrease in odds of a decile improvement in global facility rating(GDR). For each unit increase in percent patients with KT/V>=1.2 there was 10% increase in odds of a decile improvement in GDR . % AV fistula in use was only associated with 2% increase . Each unit change in phosphorus of <3.5 and > 7.0 was associated with 11% and 7% decrease odds of a decile change in facility rating. Readmission rate was associated with 2% decrease and for-profit status was associated with 67% decrease odds of GDR. There were no significant relationship with other variables.

Conclusion

Using data from dialysis facility compare, there is significant positive association between higher KT/V, AV fistula use and GDR. Hospital readmission rate, low and high serum phosphorus were negatively related to GDR . Units with more stations, and for-profit units are negatively associated with GDR. More studies are needed to understand deteminants for dialysis clearance and mineral bone disease with patients satisfaction. More is also needed to understand factors behind relationship of for-profit status and dialysis unit size with patients satisfaction.