Trends in Regional Supply of Peritoneal Dialysis in an Era of Health Reform,2006 to 2013

Abstract

Peritoneal dialysis (PD), a home-based treatment for kidney failure, is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis. Yet <10% of patients receive PD. Access to this alternative treatment, vis-à-vis providers’ supply of PD services, may be an important factor but has been sparsely studied in the current era of national payment reform for dialysis care. We describe temporal and regional variation in PD supply among Medicare-certified dialysis facilities from 2006 to 2013. The average proportion of facilities offering PD per hospital referral region increased from 40% (2006) to 43% (2013). PD supply was highest in hospital referral regions with higher percentage of facilities in urban areas (p = .004), prevalence of PD use (p < .0001), percentage of White end-stage renal disease patients (p = .02), and per capita income (p = .02). Disparities in PD access persist in rural, non-White, and low-income regions. Policy efforts to further increase regional PD supply should focus on these underserved communities.

Keywords

end-stage renal disease peritoneal dialysis access to care hospital referral regions

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References

Bhattacharya

Hyde

(2014). Health economics. Palgrave Macmillan.

Blake

P. G.

Finkelstein

F. O.

(2001). Why is the proportion of patients doing peritoneal dialysis declining in North America? Peritoneal Dialysis International, 21(2), 107-114.

Centers for Medicare & Medicaid Services. (2015). Provider of service files. https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/Provider-of-Services/index.html

Centers for Medicare & Medicaid Services. (2018). End stage renal disease (ESRD) prospective payment system (PPS). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/index.html

Centers for Medicare & Medicaid Services. (2019). Medicare program: Specialty care models to improve quality of care and reduce expenditures (Proposed Rule CMS-5527-P). Federal Register. https://www.federalregister.gov/documents/2019/07/18/2019-14902/medicare-program-specialty-care-models-to-improve-quality-of-care-and-reduce-expenditures

Cromley

E. K.

McLafferty

S. L.

(2002). GIS and public health. Guilford Press.

Dartmouth Atlas of Health Care Working Group. (2003). Geographic boundary files: Hospital referral region. Center for the Evaluative Clinical Sciences.

De Vecchi

A. F.

Dratwa

Wiedemann

M. E

. (1999). Healthcare systems and end-stage renal disease (ESRD) therapies: An international review: Costs and reimbursement/funding of ESRD therapies. Nephrology Dialysis Transplantation, 14(Suppl. 6), 31-41. https://doi.org/10.1093/ndt/14.suppl_6.31

Fitzmaurice

G. M.

(2011). Applied longitudinal analysis. Wiley.

10.

Folland

Goodman

A. C.

Stano

(2001). The economics of health and health care (3rd ed.). Prentice Hall.

11.

Furth

S. L.

Hwang

Yang

Neu

A. M.

Fivush

B. A.

Powe

N. R.

(2001). Relation between pediatric experience and treatment recommendations for children and adolescents with kidney failure. Journal of the American Medical Association, 285(8), 1027-1033. https://doi.org/10.1001/jama.285.8.1027

12.

Golper

T. A.

Saxena

A. B.

Piraino

Teitelbaum

Burkart

Finkelstein

F. O.

Abu-Alfa

(2011). Systematic barriers to the effective delivery of home dialysis in the United States: A report from the public policy/advocacy committee of the North American chapter of the international society for peritoneal dialysis. American Journal of Kidney Diseases, 58(6), 879-885. https://doi.org/10.1053/j.ajkd.2011.06.028

13.

Hao

Lovasik

B. P.

Pastan

S. O.

Chang

H. H.

Chowdhury

Patzer

R. E.

(2015). Geographic variation and neighborhood factors are associated with low rates of pre-end-stage renal disease nephrology care. Kidney International, 88(3), 614-621. https://doi.org/10.1038/ki.2015.118

14.

Hirth

R. A.

(2007). The organization and financing of kidney dialysis and transplant care in the United States of America. International Journal of Health Care Finance & Economics, 7(4), 301-318. https://doi.org/10.1007/s10754-007-9019-6

15.

Hirth

R. A.

Turenne

M. N.

Wheeler

J. R.

Nahra

T. A.

Sleeman

K. K.

Zhang

Messana

J. A.

(2013). The initial impact of Medicare’s new prospective payment system for kidney dialysis. American Journal of Kidney Diseases, 62(4), 662-669. https://doi.org/10.1053/j.ajkd.2013.03.044

16.

Hornberger

Hirth

R. A.

(2012). Financial implications of choice of dialysis type of the revised Medicare payment system: An economic analysis. American Journal of Kidney Diseases, 60(2), 280-287. https://doi.org/10.1053/j.ajkd.2012.03.010

17.

Khawar

Kalantar-Zadeh

W. K.

Johnson

Mehrotra

(2007). Is the declining use of long-term peritoneal dialysis justified by outcome data? Clinical Journal of the American Society of Nephrology, 2(6), 1317-1328. https://doi.org/10.2215/CJN.02550607

18.

Lin

Cheng

X. S.

Chin

K. K.

Zubair

Chertow

G. M.

Bendavid

Bhattacharya

(2017). Home dialysis in the prospective payment system era. Journal of the American Society of Nephrology, 28(10), 2993-3004. https://doi.org/10.1681/ASN.2017010041

19.

Macinko

de Oliveira

V. B.

Turci

M. A.

Guanais

F. C.

Bonolo

P. F.

Lima-Costa

M. F.

(2011). The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007. American Journal of Public Health, 101(10), 1963-1970. https://doi.org/10.2105/AJPH.2010.198887

20.

Mehrotra

Blake

Berman

Nolph

K. D.

(2002). An analysis of dialysis training in the United States and Canada. American Journal of Kidney Diseases, 40(1), 152-160. https://doi.org/10.1053/ajkd.2002.33924

21.

Mehrotra

Chiu

Y. W.

Kalantar-Zadeh

Bargman

Vonesh

Mehrotra

Chiu

Y.-W.

Kalantar-Zadeh

Bargman

Vonesh

(2011). Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Archives of Internal Medicine, 171(2), 110-118. https://doi.org/10.1001/archinternmed.2010.352

22.

Mehrotra

Kermah

Fried

Kalantar-Zadeh

Khawar

Norris

Nissenson

(2007). Chronic peritoneal dialysis in the United States: Declining utilization despite improving outcomes. Journal of the American Society of Nephrology, 18(10), 2781-2788. https://doi.org/10.1681/ASN.2006101130

23.

Mehrotra

Khawar

Duong

Fried

Norris

Nissenson

Kalantar-Zadeh

(2009). Ownership patterns of dialysis units and peritoneal dialysis in the United States: Utilization and outcomes. American Journal of Kidney Diseases, 54(2), 289-298. https://doi.org/10.1053/j.ajkd.2009.01.262

24.

Mendelssohn

D. C.

Mullaney

S. R.

Jung

Blake

P. G.

Mehta

R. L.

(2001). What do American nephrologists think about dialysis modality selection? American Journal of Kidney Disease, 37(1), 22-29. https://doi.org/10.1053/ajkd.2001.20635

25.

Miskulin

D. C.

Meyer

K. B.

Athienites

N. V.

Martin

A. A.

Terrin

Marsh

J. V.

Fink

N. E.

Coresh

Powe

N. R.

Klag

M. J.

Levey

A. S.

(2002). Comorbidity and other factors associated with modality selection in incident dialysis patients: The CHOICE Study. Choices for healthy outcomes in caring for end-stage renal disease. American Journal of Kidney Diseases, 39(2), 324-336. https://doi.org/10.1053/ajkd.2002.30552

26.

O’Hare

A. M.

Johansen

K. L.

Rodriguez

R. A.

(2006). Dialysis and kidney transplantation among patients living in rural areas of the United States. Kidney International, 69(2), 343-349. https://doi.org/10.1038/sj.ki.5000044

27.

Pulliam

Hakim

Lazarus

(2006). Peritoneal dialysis in large dialysis chains. Peritoneal Dialysis International, 26(4), 435-437. https://doi.org/10.1038/sj.ki.5000044

28.

Queeley

G. L.

Campbell

E. S.

(2018). Comparing treatment modalities for end-stage renal disease: A meta-analysis. American Health & Drug Benefits, 11(3), 118-127.

29.

Sloan

C. E.

Coffman

C. J.

Sanders

L. L.

Maciejewski

M. L.

Lee

S. D.

Hirth

R. A.

Wang

(2019). Trends in peritoneal dialysis use in the United States after Medicare payment reform. Clinical Journal of the American Society of Nephrology, 14(12), 1763-1772. https://doi.org/10.2215/CJN.05910519

30.

Stack

A. G.

(2002). Determinants of modality selection among incident US dialysis patients: Results from a national study. Journal of the American Society of Nephrology, 13(5), 1279-1287.

31.

Thamer

Hwang

Fink

N. E.

Sadler

J. H.

Wills

Levin

N. W.

Bass

E. B.

Levey

A. S.

Brookmeyer

Powe

N. R.

(2000). US nephrologists’ recommendation of dialysis modality: Results of a national survey. American Journal of Kidney Diseases, 36(6), 1155-1165. https://doi.org/10.1053/ajkd.2000.19829

32.

Thomas

B. A.

Rodriguez

R. A.

Boyko

E. J.

Robinson-Cohen

Fitzpatrick

A. L.

O’Hare

A. M.

(2013). Geographic variation in black-white differences in end-of-life care for patients with ESRD. Clinical Journal of the American Society of Nephrology, 8(7), 1171-1178. https://doi.org/10.2215/CJN.06780712

33.

Tong

Lesmana

Johnson

D. W.

Wong

Campbell

Craig

J. C.

(2013). The perspectives of adults living with peritoneal dialysis: Thematic synthesis of qualitative studies. American Journal of Kidney Diseases, 61(6), 873-888. https://doi.org/10.1053/j.ajkd.2012.08.045

34.

Turenne

Baker

Pearson

Cogan

Mukhopadhyay

Cope

(2018). Payment reform and health disparities: Changes in dialysis modality under the new Medicare dialysis payment system. Health Services Research, 53(3), 1430-1457. https://doi.org/10.1111/1475-6773.12713

35.

U.S. Department of Health and Human Services. (2019). Advancing American Kidney Health. https://aspe.hhs.gov/system/files/pdf/262046/AdvancingAmericanKidneyHealth.pdf

36.

U.S. Renal Data System. (2016). 2015 Annual data report and researcher’s guide to the USRDS database. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

37.

U.S. Renal Data System. (2017). USRDS 2017 annual data report: Atlas of end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

38.

U.S. Renal Data System. (2018). USRDS 2018 annual data report: Atlas of end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

39.

Venkataraman

Nolph

K. D.

(1999). Socioeconomic aspects of peritoneal dialysis in North America: Role of non medical factors in the choice of dialysis. Peritoneal Dialysis International, 19(Suppl. 2), S419-S422.

40.

Verbeke

Molenbergh

(2000). Linear mixed models for longitudinal data. Spinger-Verlag.

41.

Wang

Coffman

C. J.

Sanders

L. L.

Lee

S. Y. D.

Hirth

R. A.

Maciejewski

M. L.

(2018). Medicare’s new prospective payment system on facility provision of peritoneal dialysis. Clinical Journal of the American Society of Nephrology, 13(12), 1833-1841. https://doi.org/10.2215/CJN.05680518

42.

Wang

Lee

S. Y. D.

Patel

U. D.

Maciejewski

M. L.

Ricketts

T. C.

(2011). Longitudinal analysis of market factors associated with provision of peritoneal dialysis services. Medical Care Research and Review, 68(5), 537-558. https://doi.org/10.1177/1077558711399768

43.

Wang

Lee

S. Y. D.

Patel

U. D.

Weiner

B. J.

Ricketts

T. C.

Weinberger

(2010). Geographic and temporal trends in peritoneal dialysis services in the United States between 1995 and 2003. American Journal of Kidney Diseases, 55(6), 1079-1087. https://doi.org/10.1053/j.ajkd.2010.01.022

44.

Wang

Maciejewski

M. L.

Coffman

C. J.

Sanders

L. L.

Lee

S. D.

Hirth

Messana

(2017). Impacts of geographic distance on peritoneal dialysis utilization: Refining models of treatment selection. Health Services Research, 52(1), 35-55. https://doi.org/10.1111/1475-6773.12489

45.

Wennberg

J. E.

Cooper

M. A.

(1999). The Dartmouth Atlas of health care in the United States. American Hospital Association.

46.

Wong

Ravani

Oliver

M. J.

Holroyd-Leduc

Venturato

Garg

A. X.

Quinn

R. R.

(2018). Comparison of patient survival between hemodialysis and peritoneal dialysis among patients eligible for both modalities. American Journal of Kidney Diseases, 71(3), 344-351. https://doi.org/10.1053/j.ajkd.2017.08.028

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