The following is a summary of “Availability and quality of dialysis care in rural versus urban U.S. counties,” published in the February 2024 issue of Nephrology by Crouch et al.
Rural residents need help accessing quality dialysis care due to fewer facilities, long travel times, and limited healthcare professionals.
Researchers conducted a retrospective study to uncover disparities in dialysis care quality between rural and urban counties across the U.S.
They collected data from Medicare-certified dialysis facilities from the Centers for Medicare & Medicaid Services website (2020). To pinpoint high-need areas, they acquired county-level estimated crude prevalence of diabetes in adults from the 2022 CDC PLACES data portal. Analysis scrutinized 3,141 U.S. counties. The main focus was on whether the county had a dialysis facility. Among those counties with a dialysis facility, the average star rating, peritoneal dialysis availability, and home dialysis availability were examined.
The results showed significant variation in dialysis facility services, with peritoneal dialysis being the most common (50.8%), followed by home hemodialysis (28.5%), and late shift services (16.0%). These services are more common in urban than rural facilities. Centers for Medicare & Medicaid Services Five Star Quality ratings differed notably between urban and rural facilities, with 40.4% of rural facilities rated five stars compared to 27.1% in urban areas.
Investigators identified areas for improvement in diabetes education and interventions, particularly for residents in rural and high-need communities.
