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. 2019 Jul 4:13:1073-1082.
doi: 10.2147/PPA.S208344. eCollection 2019.

Effect of patient solicitation on mortality among patients receiving hemodialysis in Korea

Young-Ki Lee  1 , Hyung-Yun Choi  2 , Kiwon Kim  3 , AJin Cho  1 , Woo Hun Kang  4 , Young Il Choi  5 , Dae Joong Kim  6
Affiliations

Effect of patient solicitation on mortality among patients receiving hemodialysis in Korea

Young-Ki Lee et al. Patient Prefer Adherence. .

Abstract

Background: There is concern that overcompetition and illegal activities such as patient solicitation by some dialysis units may threaten patients' health in Korea. Therefore, we investigated the effect of nephrologists' patient-soliciting activity on hemodialysis practices and patients' survival using the Korean Health Insurance Review and Assessment Service database.

Methods: We selected 19 soliciting hemodialysis facilities and matched them with 19 non-soliciting facilities located nearby to eliminate location bias. Soliciting behavior was defined as the reduction of medical fees or providing money to attract dialysis patients.

Results: A total of 2,231 incident dialysis patients were included and followed for a median of 37.2 months. Soliciting facilities had a lower percentage of nephrologists, a higher average daily number of hemodialysis patients per physician, and a higher number of hemodialysis patients per nurse compared with non-soliciting facilities. Survival analysis showed that the crude mortality was significantly higher in patients treated in soliciting facilities than in those treated in non-soliciting facilities, even after adjustment for the effects of many other independently predictive covariates.

Conclusions: This study demonstrated that in Korea, the overall mortality rate in incident dialysis patients was higher in those attending soliciting facilities than in those attending non-soliciting facilities.

Keywords: hemodialysis; solicitation; survival.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

Figure 1
Figure 1
Crude Kaplan–Meier survival curves for non-soliciting facilities patients and soliciting facilities patients.
Figure 2
Figure 2
Subgroup analyses comparing hazard ratios for mortality between non-soliciting facilities patients and soliciting facilities patients.
See this image and copyright information in PMC

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