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Dialysis Facility Tracker Helps Patients Find Quality Care | New Smyrna Malpractice Attorney

Dialysis Facility Tracker Helps Patients Find Quality Care

Dialysis patients today have more choice than ever when it comes to dialysis clinics, yet most pick centers based on convenience or on what doctors suggest.

By using the Dialysis Facility Tracker at ProPublica.org, patients can search for a clinic and see how it compares on 15 key measures, ranging from mortality and hospitalization to transplant rates and infection control. Also on the site are historical reports dating to 2002.

The site became available in 2010 after ProPublica obtained the data through the Freedom of Information Act. This site is for dialysis patients and others who want to learn about the quality of care at individual dialysis clinics.

Among other things, you can learn how often patients treated at a facility have been hospitalized, report certain types of infections or are placed on the transplant list. The information is submitted by facilities and collected by contractors of the Centers for Medicare and Medicaid Services, the federal agency that oversees most dialysis care.

According to the site, there are four dialysis clinics near the 32114 zip code in Daytona Beach. When it comes to first year death rate vs. expected death rate, one center was 53 percent worse than expected and another was 109 percent worse than expected. This category compares the number of first-year deaths at these clinics to deaths that might be expected given its patient mix. Reflects adjustments for age, race, ethnicity, sex, diabetes, duration of end-stage renal care, nursing home status, body-mass index and other factors.

You can also find out what percentage of patients are on a organ waiting list at each Daytona facility, what each facility’s transplant rate is and how healthy their patients hemoglobin levels are.

There are almost 400,000 Americans who depend on chronic dialysis to do what their failed kidneys cannot, a number that has grown swiftly over the past two decades, spurred by epidemics of obesity and diabetes.

More than 5,000 facilities – 326 in Florida – have sprung up to provide them with care, stretching into the nation’s most rural areas and competing for patients in urban and suburban areas.

In more than 200 counties nationwide, the data show, the gap between facilities with the best and worst patient survival, adjusted for case-mix differences, is greater than 50 percent. In areas such as Allegheny County, Pa., or Franklin County, Ohio, each with upwards of two dozen clinics, the differences are even more substantial, exceeding 200 percent.

There is also wide variability in how often patients at different clinics are hospitalized for septicemia. Although septicemia cases can be unrelated to dialysis, it is a significant risk for patients, who typically have their blood cleaned of toxins three times a week.

Nationally, the rate was about 12 percent a year for 2006 to 2008. But in dozens of counties, the spread between facilities with the highest and lowest rates was more than 25 percentage points.

The federal government, which pays for most dialysis under a special Medicare entitlement created in 1972, has collected data on clinic outcomes and practices patterns for decades.

The Centers for Medicare and Medicaid Services contracts with the University of Michigan’s Kidney Epidemiology and Cost Center to carve this information into customized reports for each facility in the country, comparing its results to expectations based on case mix and national averages.

For years, the government has shared the reports with state health agencies to guide inspections and with dialysis facilities.

Consumer advocates say release of the data is a critical step toward patient empowerment.

With more information, patients can compare services independently and learn what questions to ask, said Lisa McGiffert, campaign director for Consumers Union’s Safe Patient Project, in a Propublica press release.

Providers also respond differently when they know their results will be out there for all to see. “Transparency is the way to make improvements happen,” McGiffert said.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.



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