Original InvestigationDialysisAssociation Between Achievement of Hemodialysis Quality-of-Care Indicators and Quality-of-Life Scores
Section snippets
Study Population
An automated reminder alerts the social worker to offer the SF-36 survey to all patients initiating dialysis therapy in Fresenius Medical Care, North America (FMCNA) facilities after their 45th day, and upon completion (or refusal to participate), at 6-month intervals thereafter. Between January 1, 2006, and December 31, 2006, a total of 61,033 maintenance HD patients from 1,084 FMCNA-legacy dialysis facilities with vintage >90 days were provided the opportunity to complete the survey. Of
Results
Characteristics of the 33,879 patients who formed our study cohort (56% response rate) are listed side by side with those from 27,154 nonresponders in Table 1. The responders' mean age was 61.5 ± 14.8 years, with 54% white, 47% women, 55% with diabetes, and a mean vintage of ∼3.7 years, similar to nonresponders' characteristics except for slight overrepresentation of white race. Mean PCS and MCS scores obtained for the study cohort were 33.2 ± 10.6 and 48.2 ± 11.2, respectively. Each of 8 SF-36
Discussion
To our knowledge, this national cross-sectional study represents the largest cohort of patients with ESRD on HD therapy with QoL information reported to date. The SF-36 response rate of 56% compares favorably with 47.6% for American patients reported in the Dialysis Outcomes and Practice Pattern Study (DOPPS).11 Responders were demographically similar to nonresponders, although there was slight overrepresentation of white race. We found the distribution of PCS and MCS scores remarkably
Acknowledgements
We thank Dr Fred Finkelstein for providing helpful suggestions for analyzing QoL information; FMCNA social workers for diligently attempting to collect QoL information from our dialysis patients; and Norma Ofsthun and Lori Vienneau for sharing their automated SF-36 scoring algorithm (in SAS) that has been used extensively in prior FMCNA projects.
Support: None.
Financial Disclosure: None.
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Originally published online as doi:10.1053/j.ajkd.2009.07.017 on September 27, 2009.