Factors Associated With Hospital Readmissions Among U.S. Dialysis Facilities. Issue 2 (29th March 2022)

• Record Type: Journal Article
• Authors: Paulus, Amber; Baernholdt, Marianne; Kear, Tamara; Jones, Terry; Thacker, Leroy
• Is Part Of: Journal for healthcare quality. Volume 44:Issue 2(2022)
• Page Start: 59
• Page End: 68
• Publication Date: 2022-03-29
• Subjects: dialysis -- ESRD -- 30-day readmission -- hospital readmissions -- care coordination; Medical care -- Quality control -- Periodicals; Quality assurance -- Periodicals; 362.1
• DOI: 10.1097/JHQ.0000000000000300
• Languages: English
• ISSNs: 1062-2551

Abstract

ABSTRACT: Introduction: The Centers for Medicare and Medicaid uses the standardized readmission ratio (SRR) to evaluate 30-day readmissions among dialysis providers in the U.S. Readmissions among dialysis recipients remains 37%. This study investigates associations among dialysis facilities and patient characteristics with facility's performance on the SRR. Methods: Descriptive, longitudinal, approach using multivariate regression analysis on data retrieved from the Dialysis Facility Report to evaluate the associations between facility-level (staffing, profit status, chain membership, clinic size, care, length of care, vascular access type, glomerular filtration rate (GFR), creatinine, hemoglobin, use of erythropoietin-stimulating agent, albumin, and primary dialysis modality) with the SRR. Results: Factors associated with a high SRR included nurse ratios, facility average GFR, and Northeast geographic location. Factors associated with a low SRR included patient care technician ratio, length of predialysis nephrology care, initiation of dialysis with an arteriovenous fistula, average hemoglobin, and Western geographic location. Conclusions: This study defines the influence predialysis nephrology care has on dialysis facilities SRRs. Access to care, adequate preparation for dialysis, and transitional support affect facilities' performance; however, without an appropriate staffing model, dialysis facilities may continue to struggle to reduce readmissions.