Ethnicity, Patient Satisfaction and Clinical Outcomes among Israeli Dialysis Recipients

Background: Patient-reported outcomes, such as satisfaction with care, are essential for assessing and improving healthcare quality, especially in populations with chronic conditions like hemodialysis patients. 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 hemodialysis patients. This study aimed evaluate patient satisfaction among the Israeli population of maintenance hemodialysis patients 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. Methods: A prospective cross-sectional cohort study of maintenance hemodialysis patients from 3 Israeli centers with similar practice patterns. Patients were recruited between April-December 2022 and followed through February 2024. Patient satisfaction was assessed via a validated self-administered questionnaire (on a Likert scale of 1-7). Clinical outcomes included all-cause mortality and kidney-transplantation rates. Results: The study included 127 hemodialysis patients, 74 of them were Israeli Jews and the remaining 53 included patients were Israeli of Arab origin. Israeli Jews were older, more often males, and had a lower prevalence of diabetes compared to Israeli Arabs (71.03±12.9 vs 60.86±13.7 years, p<0.001; 71.6% vs 52.8% male, p=0.030; 44.6% vs 79.2% with diabetes, p<0.001, respectively). Overall patient satisfaction was 6.47±1.08 among Israeli Jewish vs 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 vs 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. Conclusions: In 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.