The mortality rate among renal dialysis patients varies tremendously from one dialysis center to another.
Even adjusted for how sick the patients are, mortality is as low as 10 percent in some places, and as high as 30 percent elsewhere. And, a new study helps explains why.
“More activated and engaged patients,” better “physician communication,” and “stronger interpersonal relationships” account for much of the difference, say the study report authors. Other factors are more competent dietitians and superior overall coordination and staff management. Together, these factors explain about one-third of the difference in mortality rates between centers with high death rates and centers with low death rates.
The number of deaths prevented by the better-communicating dialysis centers is probably larger than you might expect. It appears to run in the tens of thousands every year. (The overall average mortality rate is about 20 percent.) In 2008, Medicare alone paid for renal dialysis of more than 450,000 patients.