Do more visits with kidney specialists improve dialysis patient-reported outcomes?
Highlights  Patients with kidney failure did not report better experience with care from more frequent face-to-face visits with kidney specialists at dialysis facilities. In fact, more frequent visits were linked with slightly lower patient-reported experiences with kidney-related care. Washington, DC (July 12, 2021) -- 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 kidney failure gain health benefits from more frequent visits with kidney 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 dialysis 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 visits 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 patients 4 times per month." ###  Study co-authors include Brian Brady, MD, Bo Zhao, MD, MS, Bich Dang, MD, Glenn Chertow, MD, MPH, and Wolfgang Winkelmayer MD, ScD. Disclosures: Kevin Erickson provides consulting services for Acumen LLC. Glenn Chertow is on the board of directors at Satellite Dialysis, Inc. The article, titled "Patient-Reported Experiences with Dialysis Care and Provider Visit Frequency," is available online at https:/ / cjasn. asnjournals. org/ content/ 16/ 7/ 1052 , doi: 10.2215/CJN.16621020. The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during 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 a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.