Patients with kidney failure who receive hemodialysis at US clinics located in residential areas with a high percentage of Black residents are more likely to be hospitalized than those who receive hemodialysis in communities with a lower percentage of Black residents. The findings come from a study that will be presented at ASN Kidney Week 2019 November 5-November 10 at the Walter E. Washington Convention Center in Washington, DC.
The analysis, conducted by Ladan Golestaneh MD, MS (Albert Einstein College of Medicine/Montefiore Medical Center) and her colleagues, included 4,567 patients on hemodialysis from 154 facilities in 127 zip codes in the United States. Patients receiving dialysis in communities with a high percentage of Black residents had higher hospitalization rates (32% higher for communities with ?14.4% Blacks vs. those with ?1.8% Blacks), despite having equivalent dialysis care. The association remained after adjusting for individual race, clinical comorbidities, community level poverty, and dialysis quality and adherence.
Higher risk for hospitalization in communities with a high percentage of Blacks is likely not a result of differences in quality of dialysis care, adherence practices, or clinical factors, but rather a result of as yet unidentified community level determinants of health. Healthcare disparities continue to exist even after measures taken by Centers for Medicare and Medicaid services to bridge the quality gap, through measures such as the dialysis Quality Incentive Program, to promote high-quality services in outpatient dialysis facilities in communities across the U.S."
Dr. Ladan Golestaneh, Albert Einstein College of Medicine/Montefiore Medical Center