22 May Lack of Dialysis Access for Undocumented Immigrants Stresses Patients and Providers
MedicalResearch.com Interview with:
Lilia Cervantes, M.D.
Internal Medicine, Hospitalist
Denver Health and Hospital Authority
Assistant Professor, Division of General Internal Medicine
Founder, Healthcare Interest Program and Health Equity Lecture Series
at Denver Health
University of Colorado Health Sciences Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For most undocumented immigrants with kidney failure in the U.S., access to hemodialysis is limited and they can only receive it when they are critically ill and near-death. This type of “emergency-only” hemodialysis is already known to be nearly 4-fold more costly, has 14-fold higher mortality rate, and leads to debilitating physical and psychosocial distress for these patients compared to those receiving regular hemodialysis.
This study shows that clinicians who are forced to provide this substandard care are also harmed. They experience moral distress, emotional exhaustion, and several other drives of professional burnout due to witnessing needless suffering and high mortality.
MedicalResearch.com: What should readers take away from your report?
Response: Few states have enacted programs to provide regular hemodialysis for undocumented immigrants who develop kidney failure, which are more cost effective and humane for both patients and their doctors, but these aren’t yet widespread.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies may assess the cost-effectives of inadequate care. Additionally, we may assess the perspectives of legislators, as well as the perspectives of the patients’ family members and other caregivers and the burden of emergency-only hemodialysis on them.
Cervantes L, Richardson S, Raghavan R, Hou N, Hasnain-Wynia R, Wynia MK, et al. Clinicians’ Perspectives on Providing Emergency-Only Hemodialysis to Undocumented Immigrants: A Qualitative Study. Ann Intern Med. [Epub ahead of print 22 May 2018] doi: 10.7326/M18-0400
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