Characteristics and Performance of Minority-Serving Dialysis Facilities
Version of Record online: 20 DEC 2013
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 3, pages 971–991, June 2014
How to Cite
Hall, Y. N., Xu, P., Chertow, G. M. and Himmelfarb, J. (2014), Characteristics and Performance of Minority-Serving Dialysis Facilities. Health Services Research, 49: 971–991. doi: 10.1111/1475-6773.12144
- Issue online: 16 MAY 2014
- Version of Record online: 20 DEC 2013
- National Institute of Health. Grant Numbers: K23 DK087900, K24 DK085446
- dialysis facility;
- end-stage renal disease
To examine the structure, processes, and outcomes of American dialysis facilities that predominantly treat racial-ethnic minority patients.
Data Sources/Study Setting
Secondary analysis of data from all patients who initiated dialysis during 2005–2008 in the United States.
In this retrospective cohort study, we examined the associations of the racial-ethnic composition of the dialysis facility with facility-level survival and achievement of performance targets for anemia and dialysis adequacy.
Data Collection/Extraction Methods
We obtained dialysis facility- and patient-level data from the national data registry of patients with end-stage renal disease. We linked these data with clinical performance measures from the Centers for Medicare and Medicaid Services.
Overall, minority-serving facilities were markedly larger, more often community based, and less likely to offer home dialysis than facilities serving predominantly white patients. A significantly higher proportion of minority-serving dialysis facilities exhibited worse than expected survival as compared with facilities serving predominantly white patients (p < .001 for each). However, clinical performance measures for anemia and dialysis adequacy were similar across minority-serving status.
While minority-serving facilities generally met dialysis performance targets mandated by Medicare, they exhibited worse than expected patient survival.