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The $20 billion kidney dialysis business, the nation’s first foray into universal health care, keeps growing exponentially with mixed results across the country, but here in Connecticut the news is mainly good on the ultimate measure of success — survival — with only one of the 40 clinics showing worse-than-expected mortality rates.
That’s not to say that issues of infection control, medication mistakes and a less-than-acceptable physical environment don’t crop up and find their way into clinic reports authored by personnel at the state Department of Health following surprise visits to the facilities.
The New London Dialysis Center, which is part of the private DaVita, Inc,. corporate chain, holds the distinction of having the highest mortality rates, according to data collected by the Centers for Medicare and Medicaid Services and made user-friendly by ProPublica, the Pulitizer-prize-winning investigative website.
The state and national death rate for dialysis patients is 20 percent, but at the New London center it was 30 percent from 2007-2010, 22 percent worse than expected when the patient mix is adjusted for age, sex, race, ethnicity and diabetes, CMS data shows.
The first-year mortality rate at the New London Center was 40 percent from 2007-2010, also higher than expected, where the average for the state and nation is 27 percent.
Congress, in a bipartisan move, approved full federal coverage for end stage renal disease in July 1973, the only such public health ailment in this category. Robin Fields at ProPublica said as CMS started monitoring the death rates for these dialysis patients over time, it found the rate continued to climb until 2002 where there was some improvement. First-year survival rates however, didn’t budge.
Fields, one of the main authors on ProPublica’s 2010 examination of kidney dialysis centers, said first-year death rates are more a reflection of the potential lack of health care for patients without insurance before they face kidney failure.
Fields said that “clinics with good records in this regard are important models and clinics with bad records should surely be pushed to make improvements.”
CMS also tracks the percentage of patients who have never seen a specialist before going on dialysis, something that adds to complications.
ProPublica first put data on mortality, hospitalizations, infections, clinical benchmarks and the physical conditions of clinics in the public purview two years ago after waiting since 2008 for the government to release the information under a Freedom of Information Act request. Continued...
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