Dialysis Facility Closures in the US From 2018 to 2024: A Serial Cross-Sectional Study

Area of Science:

• Nephrology
• Healthcare Management
• Public Health

Background:

• Dialysis facility growth in the US showed a steady increase from 2006-2016.
• Recent trends suggest a potential reversal in the number of operational dialysis facilities.
• Understanding closure patterns is crucial for healthcare access and patient care.

Purpose of the Study:

• To examine trends in US dialysis facility closures between 2018 and 2024.
• To identify facility- and neighborhood-level characteristics associated with dialysis facility closures.
• To assess the impact on different geographic and demographic areas.

Main Methods:

• A serial cross-sectional study design was employed, analyzing data from 2018 through 2024.
• Dialysis facility data from the Centers for Medicare and Medicaid Services were linked with demographic and socioeconomic data.
• Characteristics analyzed included facility size, profit status, payer mix, geographic location, and neighborhood social vulnerability.

Main Results:

• Dialysis facility closures exceeded openings from late 2021 through early 2024.
• Smaller facilities, those in rural areas, and those in the Midwest region were disproportionately affected by closures.
• Closed facilities served a higher proportion of patients with dual Medicare and Medicaid eligibility.

Conclusions:

• A nationwide increase in dialysis facility closures occurred between 2018 and 2024.
• Rural and Midwest communities, along with smaller dialysis facilities, faced a greater impact.
• Further research is needed to understand the patient-level implications of these closure trends.