Report argues longer travel time significantly increases patients' probability of death
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Dialysis patient Nathan Bushey says he hopes a report commissioned by the P.E.I. Islandwide Dialysis Patient Support Group will be considered as government continues to mull over the future of dialysis in Souris and Alberton.
Closing dialysis service in Souris and Alberton is a more expensive and potentially deadly option for some patients, according to a consultant’s report.
The report, entitled Ensuring Access to Healthcare: Maintaining Local Dialysis, cites data from numerous medical journals and studies, making the case that consolidating dialysis services in Charlottetown and Summerside would cost Health P.E.I. more money, would not improve patient outcomes and would increase the likelihood of death in some of those forced to travel longer distances for treatment.
The report was commissioned by the P.E.I. Islandwide Dialysis Patient Support Group, which has been fighting to keep dialysis open in the Souris and Alberton hospitals.
It was written by Alan Buchanan, a former provincial health minister who now works as a private consultant.
The group’s spokesperson, Souris Mayor David MacDonald, said they wanted to present government with scientific evidence to support their belief that hemodialysis in P.E.I.’s rural hospitals should not be relocated.
“I think the report shows quite clearly that dialysis is much better delivered in a local environment,” MacDonald said.
“We still have no rationale from government for their decision to close our local dialysis unit. It was simply an announcement. Period. And we just didn’t figure that was adequate.”
Last spring, Health Minister Doug Currie announced a consolidation of hemodialysis services in the province from four locations to two expanded ones in Charlottetown and Summerside. This would shut down dialysis treatment currently being offered at Western Hospital in Alberton and in Souris Hospital.
The decision sparked uproar from these two communities and they immediately began to push back. A large protest was held at Province House last May.
Currie later agreed to delay this change for a year to allow for more consultation with the communities involved.
But several members of the P.E.I. Islandwide Dialysis Patient Support Group say Currie has not reached out to them at all.
“We couldn’t understand why government announced this closure. The evidence that we had seemed to indicate that it made no sense,” said committee member Alan MacPhee.
“We asked government for written rationale on the decision, but government didn’t provide any written rationale… they’ve provided no information.”
That’s why the group commissioned their own analysis.
“We can conclude that the proposed consolidation of dialysis does not meet Health P.E.I.’s own test of fair and timely access to care." Ensuring Access to Healthcare: Maintaining Local Dialysis
Their report looks at the viability of dialysis services in satellite locations and how this would apply to the stated objectives and policies of Health P.E.I.
It points out the health agency’s vision statement says P.E.I.’s health system is focused on ‘meeting needs in the most appropriate setting, by the most appropriate provider in the most cost effective manner.’
“In the instance of hemodialysis services and the decision to discontinue local dialysis, Health P.E.I. appears to have taken a contrary approach,” the report states.
“It is instead pushing the patient to the most expensive level of care (specialist services) and one which has been shown to have less bearing on both the medical and quality of life outcomes than other variables and factors in the hemodialysis treatment regimen.”
The report also argues longer travel time for patients on dialysis significantly increases their probability of death.
A large-scale international outcomes study found dialysis patients who had to travel an hour or more had a 20 per cent increase in mortality and a 10 per cent increase in withdrawal, skipping of treatments or shortened sessions due to travel difficulties.
“We can conclude that the proposed consolidation of dialysis does not meet Health P.E.I.’s own test of fair and timely access to care,” Buchanan’s report states.
“While an hour of travel for the occasional treatment of a chronic condition would normally be regarded as reasonable, a burden of travel that so dramatically shortens one’s lifespan cannot be similarly accepted.”
The report was sent to Currie, Premier Robert Ghiz and to acting Health P.E.I. CEO Dr. Richard Wedge.
Dialysis patient Nathan Bushey said he hopes the report will be considered as government continues to mull over the future of dialysis in Souris and Alberton.
“Good ministers make good decisions with good information, and we’re providing good information so I expect they will keep the units open.”
The P.E.I. Islandwide Dialysis Patient Support Group will be holding a roundtable discussion on March 26 to discuss the report. Ghiz, Currie and Wedge have been invited to take part in this discussion.
No one from government was made available for comment on this story.