title: CMS-required visits adversely impact Seattle area hemodialysis program.
abstract: Chronic hemodialysis in Seattle developed with a highly patient-centric approach, providing patients the option of dialyzing in neighborhood units under the administration of a non-profit organization, the Northwest Kidney Center (NKC). This study examined the effects of a requirement in the 2009 Conditions for Coverage that in-center hemodialysis patients be visited quarterly during their treatment session. A retrospective analysis of quality outcome indicators for patients managed at the University of Washington Medical Center and dialyzing at NKC in 2008 and 2010 found that dialysis adequacy (eKt/V), phosphorus, albumin, and hemoglobin were not improved by quarterly dialysis visits. Instead, dialysis unit visits adversely impacted patient-nephrologist relationships and diverted nephrologists from other patient care activities.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Muczynski
authors.forename: Susan K
authors.initials: SK
authors.lastname: Anderson
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D006435:Renal Dialysis; D018570:Risk Assessment; D014481:United States; D014861:Washington