To describe trends in treatment patterns of Small Dialysis Organizations (SDOs) prior to and during the implementation of the Centers for Medicare and Medicaid Services' (CMS') policy \[End Stage Renal Disease (ESRD) Prospective Payment System (PPS)\] to bundle reimbursement for all dialysis services. Specifically, to describe CMS ESRD PPS quality performance measures for dialysis centers over time.
Study Type
OBSERVATIONAL
Enrollment
2,248
Percentage of Participants Per Facility With Hemoglobin < 10 g/dL
The percentage of participants within each small dialysis organization (SDO) facility with hemoglobin \< 10 g/dL over time. Percentage of participants meeting the criteria at the facility-level were calculated for each facility first and then summarized across facilities as a continuous variable, weighted by the number of participants in a facility.
Time frame: Data were collected monthly from June 2010 until September 2012
Percentage of Participants Per Facility With Hemoglobin > 12 g/dL
The percentage of participants within each small dialysis organization (SDO) facility with hemoglobin \> 12 g/dL over time. Percentage of participants meeting the criteria at the facility-level were calculated for each facility first and then summarized across facilities as a continuous variable, weighted by the number of participants in a facility.
Time frame: Data were collected monthly from June 2010 until September 2012
Percentage of Participants Per Facility With Urea Reduction Ratio (URR) ≥ 65%
The percentage of participants within each small dialysis organization (SDO) facility with a urea reduction ratio ≥ 65% over time. URR is calculated as: Baseline urea level - post-baseline urea level/baseline urea level \* 100. Percentage of participants meeting the criteria at the facility-level were calculated for each facility first and then summarized across facilities as a continuous variable, weighted by the number of participants in a facility.
Time frame: Data were collected monthly from June 2010 until September 2012
Percentage of Participants Treated by Each Dialysis Modality
The percentage of participants treated with peritoneal, hemodialysis (in center) or home hemodialysis over the course of the study. For participants who switched modalities within a quarter, the last current modality is reported.
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
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Research Site
Gulf Shores, Alabama, United States
Research Site
Siloam Springs, Arkansas, United States
Research Site
Springdale, Arkansas, United States
Research Site
Azusa, California, United States
Research Site
Bakersfield, California, United States
Research Site
Covina, California, United States
Research Site
Glendale, California, United States
Research Site
Hacienda Heights, California, United States
Research Site
Inglewood, California, United States
Research Site
Lancaster, California, United States
...and 31 more locations
Percentage of Participants in Each Vascular Access Type Category
The percentage of participants in each vascular access type category out of all enrolled participants on hemodialysis over the course of the study.
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Percentage of Participants Per Facility Receiving Erythropoietin Stimulation Agents (ESA)
The percentage of participants who received erythropoietin stimulation agents (ESA) in a facility over the course of the study. Mean and confidence interval (CI) are calculated across facilities and by using total number of participants actively receiving chronic dialysis in each facility per month as weight.
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Percentage of Participants Receiving Cinacalcet
The percentage of participants receiving cinacalcet (Sensipar) over time
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Percentage of Participants Receiving Phosphate Binding Agents
The percentage of participants receiving phosphate binding agents over time
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Percentage of Participants Receiving a Vitamin D Sterol
The percentage of participants receiving a vitamin D sterol (ie, calcitriol, alfacalcidol, paricalcitol or doxercalciferol) over time. Note that participants could receive more than one type of vitamin D sterol.
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Mean Hemoglobin Concentration by Quarter
Time frame: Fourth quarter (Q4) 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.
Distribution of Facilities With Percentage of Participants With Hemoglobin < 10 g/dL Over Time
Facilities were categorized over time based on the percentage of participants at the facility with hemoglobin \< 10 g/dL: Faciities with 0 to \<5% of participants with hemoglobin \< 10 g/dL; Facilities with 5 to \< 10% of participants with hemoglobin \< 10 g/dL; Facilities with 10 to \< 15% participants with hemoglobin \< 10 g/dL; Facilities with 15 to \< 20% of participants with hemoglobin \< 10 g/dL; Facilities with ≥ 20% of participants with hemoglobin \< 10 g/dL.
Time frame: December 2010, March 2011, June 2011, September 2011, December 2011
Percentage of Participants Per Facility With Transferrin Saturation < 20% and Ferritin Level < 100 ng/mL
The mean percentage of participants per facility with transferrin saturation \< 20% and ferritin level \< 100 ng/mL. Mean and CI are calculated across facilities and by using number of participants with non-missing transferrin saturation and ferritin in each facility as weight.
Time frame: December 2010, March 2011, June 2011, September 2011, December 2011
Cumulative Monthly Dose of Epoetin Alfa Administered
The cumulative monthly intravenous epoetin alfa dose in participants on hemodialysis.
Time frame: December 2010, March 2011, June 2011, September 2011, December 2011
Number of Participants Taking Epoetin Alfa by Month
The number of participants who took epoetin alfa only, by month, in participants on hemodialysis.
Time frame: December 2010, March 2011, June 2011, September 2011, December 2011
Number of Participants With Transfusions, Hospitalizations, Mortality, and Transfers Out
Time frame: June to December 2010, Q1 2011, Q2 2011, Q3 2011, and Q4 2011.