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Outcomes/Effectiveness Research

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Both the nature of physician contact and visit frequency are important factors in hemodialysis patient outcomes

It is commonly thought that chronic disease patients fare better when they see their doctor more often. However, a new study of hemodialysis patients suggests that the nature of physician contact (for example, data gathering and partnership building) and behind-the-scenes care of doctors on behalf of their patients (for example, overseeing care plans and communicating with nurses, nutritionists, and technicians) may be just as important to patient outcomes.

In the study, which was supported in part by the Agency for Healthcare Research and Quality (HS08365), researchers examined the relationship between the frequency of patient-physician contact and several outcomes of patients with chronic kidney disease treated at 75 U.S. dialysis clinics. They used a clinic survey to determine the average frequency of patient-physician contact at each clinic (low, monthly or less frequently; intermediate, between monthly and weekly; high, more than weekly).

Patients treated at low-frequency clinics were 61 percent less likely than patients at high-frequency clinics to rate the frequency at which they saw a nephrologist as excellent, and those at intermediate-frequency clinics were 43 percent less likely to do so. These patients were also 2.89 times and 1.58 times as likely, respectively, to not adhere to their hemodialysis treatment as patients at high-frequency clinics. However, patient survival did not vary by frequency of physician contact, nor did patients' overall ratings of care, hospitalization rates, or quality of life measures.

See "Frequency of patient-physician contact and patient outcomes in hemodialysis care," by Laura C. Plantinga, M.S., Nancy E. Fink, M.P.H., John H. Sadler, M.D., and others, in the Journal of the American Society of Nephrology 15, pp. 210-218, 2004.

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