title: Satisfaction with Care of Patients on Hemodialysis.
abstract: OBJECTIVE
  Little is known about patients receiving dialysis who respond to satisfaction and experience of care surveys and those who do not respond, nor is much known about the corollaries of satisfaction. This study examined factors predicting response to Dialysis Clinic, Inc. (DCI)'s patient satisfaction survey and factors associated with higher satisfaction among responders.
  A total of 10,628 patients receiving in-center hemodialysis care at 201 DCI facilities between January 1, 2011, and December 31, 2011, aged ≥18 years, treated during the survey administration window, and at the facility for ≥3 months before survey administration. Primary outcome was response to at least one of the nine survey questions; secondary outcome was overall satisfaction with care.
  
  
  RESULTS
  Response rate was 77.3%. In adjusted logistic regression (odds ratios with 95% confidence intervals), race other than black (white race, 1.23 [1.10 to 1.37]), missed treatments (1.16 [1.02 to 1.32]) or shortened treatments (≥5 treatments, 1.40 [1.22 to 1.60]), more hospital days (>3 days in the last 3 months, 1.89 [1.66 to 2.15]), and lower serum albumin (albumin level <3.5 g/dl, 1.4 [1.28 to 1.73]) all independently predicted nonresponse. In adjusted linear regression, the following were more satisfied with care: older patients (age ≥63 years, 1.84 [1.78 to 1.90]; age <63 years, 1.91 [1.86 to 1.97]; P<0.001), white patients (1.76 [1.71 to 1.81]) versus black patients (1.93 [1.88 to 1.99]) or those of other race (1.93 [1.83 to 2.03]) (P<0.001), patients with shorter duration of dialysis (≤2.5 years, 1.79 [1.73 to 1.84]; >2.5 years, 1.96 [1.91 to 2.02]; P<0.001), patients who had missed one or fewer treatments (1.83 [1.78 to 1.88]) versus those who had missed more than one treatment (1.92 [1.85 to 1.98]; P=0.002) and those who had shortened treatment (for one treatment or less, 1.84 [1.77 to 1.90]; for two to four treatments, 1.87 [1.81 to 1.93]; for five or more treatments, 1.92 [1.87 to 1.98]; P=0.004).
  
  
  CONCLUSIONS
  Survey results represent healthier and more adherent patients on hemodialysis. Shorter survey administration windows were associated with higher response rates. Older, white patients with shorter dialysis vintage were more satisfied.
authors.affiliation: William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts; mrichardson@tuftsmedicalcenter.org.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Richardson
authors.affiliation: Dialysis Clinic, Inc., Quality Management, Albuquerque, New Mexico;
authors.forename: Susan S
authors.initials: SS
authors.lastname: Paine
authors.affiliation: Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts;
authors.forename: Megan E
authors.initials: ME
authors.lastname: Grobert
authors.affiliation: Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; and.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Stidley
authors.affiliation: Department of Medicine, Division of Adult Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Ezra
authors.initials: E
authors.lastname: Gabbay
authors.affiliation: Dialysis Clinic, Inc., Quality Management, Albuquerque, New Mexico; Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; and.
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Harford
authors.affiliation: Dialysis Clinic, Inc., Quality Management, Albuquerque, New Mexico; Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; and.
authors.forename: Philip G
authors.initials: PG
authors.lastname: Zager
authors.affiliation: William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts;
authors.forename: Dana C
authors.initials: DC
authors.lastname: Miskulin
authors.affiliation: William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; Dialysis Clinic, Inc., Outcomes Monitoring Program, Boston, Massachusetts;
authors.forename: Klemens B
authors.initials: KB
authors.lastname: Meyer
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D017060:Patient Satisfaction; D006435:Renal Dialysis / Q000009:adverse effects / Q000523:psychology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People / Q000523:psychology
keywords: chronic hemodialysis; clinical epidemiology; epidemiology and outcomes