Ethnicity, Patient Satisfaction, and Clinical Outcomes among Israeli Dialysis Recipients

Abstract

Key PointsGrowing interest in health-related quality of life underscores the need to explore patient satisfaction among diverse dialysis populations.In this study, patient ethnicity in Israel showed no significant effect on satisfaction, mortality, or transplantation outcomes.Dialysis vintage and patient age were key predictors of satisfaction and survival, highlighting areas for targeted interventions.BackgroundPatient-reported outcomes, such as satisfaction with care, are essential for assessing and improving health care quality, especially in populations with chronic conditions such as patients with hemodialysis. In diverse societies, understanding how ethnic background influences patient satisfaction and clinical outcomes is crucial for addressing health disparities. However, the relationship between ethnic background, patient satisfaction, and clinical outcomes has not been thoroughly investigated in Israeli patients on hemodialysis. The aim of this study was to evaluate patient satisfaction among the Israeli population of patients on maintenance hemodialysis and its correlation with clinical and demographic variables, including a potential association with ethnicity. In addition to assessing patient satisfaction, we also evaluated the association between ethnicity and clinical outcomes.MethodsThis is a prospective cross-sectional cohort study of patients on maintenance hemodialysis from three Israeli centers with similar practice patterns. Patients were recruited between April and December 2022 and followed through February 2024. Patient satisfaction was assessed using a validated self-administered questionnaire (on a Likert scale of 1-7). Clinical outcomes included all-cause mortality and kidney transplantation rates.ResultsThe study included 127 patients on hemodialysis, 74 of whom were Israeli Jews and the remaining 53 included patients of Israeli Arab origin. Israeli Jews were older, were more often male, and had a lower prevalence of diabetes compared with Israeli Arabs (71.03±12.9 versus 60.86±13.7 years, P < 0.001; 71.6% versus 52.8% male, P = 0.030; 44.6% versus 79.2% with diabetes, P < 0.001, respectively). Overall patient satisfaction was 6.47±1.08 among Israeli Jewish versus 6.83±0.68 among Israeli Arab patients (P = 0.017) from dialysis clinic, whereas the mean patients' satisfaction survey was 5.58±1.08 versus 5.79±0.79, respectively, P = 0.226. Ethnicity was not associated with mortality and transplantation. Dialysis vintage and patient age were the strongest predictors of patient satisfaction and mortality.ConclusionsIn Israeli dialysis centers, patient ethnicity was not associated with patient-reported satisfaction or objective clinical outcomes including mortality and transplantation rates. Larger cohort studies to assess levels of satisfaction longitudinally are indicated.