Patients at for-profit kidney dialysis centers are less likely to receive kidney transplants than those at nonprofit centers, according to a Sept. 10 study published by researchers at Emory and health care company Kaiser Permanente.
Dialysis is a medical treatment that substitutes the kidney’s functions by removing excess water, salt and toxins and regulating other chemicals in the bloodstream for patients with kidney failure. Kaiser Permanente reported that dialysis is often more expensive, time consuming and dangerous than a kidney transplant.
Though the study did not research the reason why patients at for-profit centers are less likely to receive transplants, Director of the Transplant Health Services and Outcomes Research Program at Emory and the study’s senior author Rachel Patzer offered the potential explanation that for-profit centers are financially motivated to keep their patients on dialysis.
“For-profit dialysis facilities make more profit when they have more patients on dialysis, meaning they don’t send them to get a transplant,” Patzer said.
The study examined publicly available national data from 2000 to 2016 on over one million patients with end-stage kidney disease. The researchers found that during that time, patients at for-profit centers were 64 percent less likely to get on a waiting list or receive a kidney from a living or dead donor.
Patzer hypothesized that this disparity could exist because for-profit centers engage in activities that may discourage their patients from getting transplants, such as providing fewer referrals for transplantation. Patzer hopes to test her explanation in an upcoming study.
She and her team have already collected data on referral rates in Georgia, North Carolina and South Carolina, and plan to expand their study to more states.
Patzer recommended that lawmakers create financial motivation for centers to take their patients off dialysis.
“If we can incentivize dialysis facilities by rewarding them financially for patients that they are … sending to get evaluated for a transplant, that’s a good thing for patients, and it could be a good thing for the health system,” Patzer said.