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While end-of-life planning may be more common by providers and patients, there are “substantial” racial disparities when it comes to hospice use among some older adults, according to a new study. Researchers found that end-stage renal disease (ESRD) patients who were African American or Native American were 44 percent less likely to take use hospice care than white patients. Asian-Americans were 43 percent less likely to do so. Continue reading
On the heels of a successful FOIA request related to Robin Fields’ dialysis investigation, ProPublica has published a database evaluating dialysis clinics on 15 different measures. The information has been available to state health agencies for years, but this is the first time it’s been released for general public consumption, Fields writes.
Patients have long chosen dialysis clinics based only on location or physician recommendation, even though the data shows a wide variation in quality among the 5,000-plus such facilities nationwide.
In more than 200 counties nationwide, the data show, the gap between facilities with the best and worst patient survival, adjusted for case-mix differences, is greater than 50 percent. In areas such as Allegheny County, Pa., or Franklin County, Ohio, each with upwards of two dozen clinics, the differences are even more substantial, exceeding 200 percent.
There is also wide variability in how often patients at different clinics are hospitalized for septicemia. Although septicemia cases can be unrelated to dialysis, it is a significant risk for patients, who typically have their blood cleaned of toxins three times a week. Nationally, the rate was about 12 percent a year for 2006 to 2008. But in dozens of counties, the spread between facilities with the highest and lowest rates was more than 25 percentage points.
Like Dollars for Docs, this new database should provide plenty of ready localizations of of the story.
Josephine Marcotty of the Minneapolis Star Tribune recently wrote a series addressing the increasing demand for kidneys, a need spurred by an aging population, increases in diabetes, obesity and high-blood pressure. 
She found that it is a public health crisis that costs the nation $33.6 billion a year, and there is no end in sight.
Marcotty covered one woman’s search for a kidney, the ethics of paired donations and how the medical center decided who would get organs.
In this article for AHCJ members, she shares what she learned about kidney donation and how she reported the story.
