The “Home” Setting Is Best

Background

DSS Research created a “home survey” to capture the level of satisfaction of consumers receiving dialysis treatments in a home setting.  After several implementations of the home survey, comparisons were made between the home survey results and the more traditional in-center setting.  In-center results were collected using the ICH CAHPS® instrument across a variety of facilities and clients.  Since the home survey leveraged the key questions from the official ICH CAHPS questionnaire, direct comparisons between in-center and home dialysis patients were readily available.

Data

We have two years of home dialysis survey results using both mail and telephone data collection in a mixed-mode approach.  DSS compared these data to four years of ICH CAHPS research collected using the same mixed-mode methodology of mail surveys upfront and telephone calls to non-responders.

Results

Satisfied.  Overall ratings are high with 65% to 70% of dialysis patients rating their doctor, the staff and the center a 9 or 10 and over 80% rating these factors an 8, 9 or 10. On average, almost 86% of survey respondents said they always or usually receive a high level of service on a variety of items in the ICH survey.

Consistent.  Satisfaction ratings and affirmations of various statements related to their treatment and ongoing care have remained very consistent since the inception of the ICH CAHPS program.  Over the last four waves (Spring and Fall 2015; Spring and Fall 2016), only a handful of measures have declined or improved from one wave to the next by more than 5% on a relative or absolute basis.

Equivalent.  The phone and mail methodologies produce similar results.  Average satisfaction ratings between mail and phone data collection methodologies are very similar.  Phone respondents are one percentage point higher on Top 2 box scores and two percentage points higher on Top 3 box scores on the overall satisfaction scales with 0 to 10-point scales.

Home and In-center patients very similar

Home care and in-center dialysis patients have similar perceptions of their health status

Situational.  Those receiving home dialysis treatments are significantly more satisfied than in-center dialysis patients on aspects related to their training, care and general feelings about the dialysis center coordinating their care.  Training nurses for home dialysis patients are rated significantly higher than staff members at dialysis centers.  However, almost 50% of home patients have experienced some type of problem during dialysis, much more often than the typical in-center patient (an average of 27% have experienced a problem in the last three months).  Home dialysis patients are also somewhat less likely to say they were able to handle dialysis problems on their own.  Physical and mental health ratings are comparable between in-center and home dialysis patients, but home patients are healthier overall with significantly fewer patients reporting having high blood pressure, a heart condition or diabetes and fewer saying they have vision or hearing problems.

Home patients are more satisfied

Home dialysis patients are more satisfied than In-center dialysis patients

 

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