Abstract: FR-PO804

In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey Non-Responder and Responder Characteristics

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Dad, Taimur, Tufts Medical Center, Boston, Massachusetts, United States
  • Tighiouart, Hocine, Tufts Medical Center, Boston, Massachusetts, United States
  • Grobert, Megan, Dialysis Clinic Inc, Boston, Massachusetts, United States
  • Lacson, Eduardo K., Tufts Medical Center, Boston, Massachusetts, United States
  • Meyer, Klemens B., Tufts Medical Center, Boston, Massachusetts, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
  • Richardson, Michelle M., Tufts Medical Center, Boston, Massachusetts, United States
Background

The In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey assessing patient experience is a performance metric in the End Stage Renal Disease Quality Incentive Program administered twice yearly to adult, in-center hemodialysis patients. Response rates currently are approximately 35% and little is known about characteristics of non-responders.

Methods

Cross-sectional analysis of ICH CAHPS administration in 2012 to all ICH patients in Dialysis Clinic, Inc. (DCI) facilities nationally who met AHRQ eligibility criteria for survey administration (over 18 years old and receiving HD at their facility for at least 3 months). Patient-level covariates include demographic, clinical, laboratory, and functional characteristics. Outcome was survey response using AHRQ’s definition of response (no proxy help and answers to at least 50% of pre-defined key questions).

Results

Among 11,055 patients eligible for ICH CAHPS, 6,541 (59%) did not return the mail survey or complete the alternative phone survey and 5,372 (82%) of these had complete covariate data. Of 3,918 responders with complete data (87% of responders), 549 (14%) did not meet AHRQ’s definition of response. Using random effects multivariable logistic models, non-responders were more likely to be men, non-white, younger, single, dual Medicare/Medicaid eligible, less educated, non-English speaking, not active on the transplant list, have longer ESRD vintage, lower BMI, lower serum albumin, worse functional status, and more hospitalizations, missed treatments, and shortened treatments. Similar associations were found using more parsimonious multivariable analyses and after imputing missing data.

Conclusion

In 2012, survey non-responders significantly differed from responders raising concern for bias in survey results. Future research should assess and address reasons for non-response to improve survey applicability.

Funding

  • Other NIH Support