Researchers at the Emory University School of Medicine have developed a new method for determining how consistently dialysis facilities refer patients for transplantation. Referrals from dialysis facilities are a crucial step for those waiting to receive a transplant, a process that on average takes up to 3-5 years. The study found that of the roughly 700,000 patients in the US with end-stage renal disease (ESRD), only 77% of dialysis facilities referred them as expected.
Rachel Patzer, PhD, MPH, along with her colleagues, established the Standardized Transplantation Referral Ratio (STReR). It was applied to data from 249 facilities in the state of Georgia to gauge the consistency with which 8,308 kidney failure patients were referred for transplant from years 2008-2011. The study found that on average, 33% of the STReR variation occurred between facilities and the majority, 67% within-facilities.
Factors influencing the probability of referral are age, race, sex, and comorbid conditions. However, most of the variability is attributed to dialysis-facility differences rather than patient factors. The study provides a framework for standardizing referral activity and gauging dialysis facility performance. Dr. Patzer says by monitoring this activity, she hopes to “drive quality improvement and increase access to kidney transplantation”.
The full study can be found in the latest issue of the Clinical Journal of the American Society of Nephrology (CJASN).
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