US dialysis center technician staffing varies widely by region, may impact quality of care
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Key takeaways:
- Median patient-to-patient care technician ratio among U.S. facilities was 9.9:1.
- The percentage of unfilled positions went from 2.8% to 3.5% during the study period.
Patient care technician staffing at U.S. dialysis facilities varies by geography, time and other attributes, data show. Further investigation could lead to better quality of care, according to published data.
“Although the number of technicians caring for patients receiving dialysis continues to grow with the patient population ... and several states have instituted dialysis staffing mandates, little is known about how patient care technician staffing patterns differ across U.S. dialysis facilities,” Laura C. Plantinga, PhD, of the rheumatology and nephrology divisions at the University of California, San Francisco, and colleagues wrote in the study.
Researchers conducted an ecological study, including 6,862 in-center hemodialysis facilities identified through the U.S. Renal Data System in 2019. The goal was to provide a comprehensive description and find correlates in patient care technician staffing patterns.
Researchers studied geography, year and facility traits, including aggregated patient characteristics. Main outcome was facility-reported patient-to-patient care technician ratio.
Median patient-to-patient care technician ratio among the facilities was 9.9:1, results showed, while median patient-to-patient care technician ratios varied substantially by state and region. There was an overall decrease in median ratio from 10.6:1 in 2004 to 9.9:1 in 2019. The percentage of unfilled positions went from 2.8% to 3.5% during the same period.
Large dialysis organizations and larger facility sizes were associated with lower ratios, indicating better staffing levels, researchers wrote. Higher ratios were linked to factors, such as patient-to-registered nurse and patient-to-social worker ratios, presence of licensed vocational nurses or licensed practical nurses, and locations in poverty areas.
“Future studies, including both observational and intervention studies, could use these data to generate hypotheses and target facilities for interventions, addressing some of the limitations in our study by collecting more detailed pre- and post-pandemic staffing data; provider-level data on burnout, work experiences and turnover intention; and facility- and/or patient-level data on quality of care and outcomes,” the researchers wrote.
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