Abstract: SA-PO779

Patient Characteristics Associated with the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Scores

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 is a mandatory assessment of patient experience of ICH patients. To better understand performance on this quality metric, we evaluated patient characteristics associated with high ICH CAHPS scores.

Methods

Cross-sectional analysis of ICH CAHPS scores in 2012 to all ICH patients in Dialysis Clinic, Inc (DCI) facilities. Eligibility criteria determined by AHRQ included > 18 years old and received dialysis at the current facility for > 3 months. Measures include patient-level demographic, clinical, laboratory, and functional characteristics. Outcomes include “top box” scores for the three global rating scores for the nephrologist, dialysis facility staff, and dialysis facility and three composite scores ‘Nephrologists’ Communication and Caring’ (Comm), ‘Quality of Dialysis Center Care and Operations’ (Qual), and ‘Providing Information to Patients’ (Info). “Top box” was defined by AHRQ as >8 for global rating scores (scale 0-10 with 10 being the best) and either “Always” (from Always, Usually, Sometimes, Never) or “Yes” (from Yes, No) answer choice to questions within each composite.

Results

Among 11,055 eligible patients, 4,514 (41%) returned the survey or completed it by phone. In random intercept multivariable logistic models which accounted for dialysis facility effect, older age and lower education were consistently associated with higher odds of top box scores for all three global ratings. Among composite outcomes, higher Kt/V (Comm), lower education (Qual), and being active on the transplant list (Info) were associated with higher odds of top box scores. Shortened treatments were associated with lower odds for a top box score for all global ratings and the Comm composite. Results were similar after imputing missing predictor data.

Conclusion

Older age and lower educational level were associated with higher global rating scores while higher Kt/V, lower educational level, and being active on the kidney transplant list were associated with higher composite scores. Our findings raise concern about dialysis facility scores being influenced by patient case-mix with associated expectations of care experience.

Funding

  • Other NIH Support