Clinical InvestigationPatient-reported outcomes and experiences in the transition of undocumented patients from emergency to scheduled hemodialysis
Graphical abstract
Section snippets
Participants and characteristics
All 30 (10 women and 20 men) approached agreed to participate. Participants had a mean age of 51.7 ± 10.6 years and a mean Charlson Comorbidity Index score of 5.5 ± 1.8, and all (100%) participants preferred that the interview be conducted in Spanish. The majority (83%) had a “less than high school education” and an income of ≤$15,000 (93%) and had been on dialysis for a mean of 47 ± 45 months. The second interview took place a mean of 5.0 ± 1.7 months after transition (Table 1). Two
Discussion
An increasing number of US states are contemplating a change to a more equitable, efficient, and humane policy to allow undocumented immigrants to access scheduled dialysis. In the state of Colorado, where this changed occurred, undocumented immigrants experienced an improvement (ranging from 13% to 166%) in all 5 quality of life subscales and an improvement (ranging from 57% to 100%) in 7 symptoms. Trust in physicians and satisfaction with care were largely the same. Patients had apprehension
Study design
We conducted a pre-post intervention (before and after transition from emergency to scheduled hemodialysis), mixed methods (questionnaires and qualitative semi-structured interviews) study. Consolidated Criteria for Reporting Qualitative Research was used to report this study (Supplementary Table S2).16 The multi-institutional review boards of the University of Colorado Denver approved this study.
Participants and setting
Eligible participants were English- or Spanish-speaking undocumented immigrant adults (≥18 years
Disclosure
All the authors declared no competing interests.
Acknowledgments
This study was made possible by an internal grant from the University of Colorado School of Medicine and the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK117018). The funders of this study had no role in study design; collection, analysis, and interpretation of data; manuscript writing; or decision to submit the manuscript for publication.
Author Contributions
LC and NRP designed the study. CC carried out the interviews. AT, LC, and AC analyzed the data. LC, NRP, AT, CC, and AC made the
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2022, Kidney InternationalCitation Excerpt :When the methods and, most importantly, the findings are integrated, mixed-methods approaches provide a greater insight into a problem than can any single method.11 For example, a team of researchers in the USA aimed to understand the outcomes and experiences of undocumented immigrants when they transitioned from emergency dialysis provision to regular scheduled treatment.12 The researchers employed a mixed-methods approach undertaking quantitative questionnaires and in-depth qualitative interviews with individuals receiving dialysis before and after they moved from emergency to regular treatment.
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see commentary on page 26