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Abstract: TH-PO281

Can Dialysis Facility Compare (DFC) Star Ratings Inform Patient Choice of Dialysis Facility? Geographic Co-Location of Facilities by Star Rating Category

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Salerno, Stephen, University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Gremel, Garrett Wolfgang, University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Hirth, Richard A., University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Li, Yi, University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Dahlerus, Claudia, University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Tong, Lan, University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
  • Messana, J. M., University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, Michigan, United States
Background

Beginning in 2015, Medicare’s DFC site implemented a Star Rating system summarizing the selected clinical quality measures reported on DFC. The Star Ratings are intended to provide an easily interpretable summary of dialysis facility’s quality performance and to assist consumer decision-making. We hypothesize that patients’ choice of dialysis facility might be influenced by the reported Star Ratings, particularly for those whose choice is not limited by distance to a dialysis facility.

Methods

Based on facilities’ zip codes and their reported Star Ratings on DFC, we geocoded all 6000+ dialysis facilities in the contiguous U.S.. Facilities with lower star rating performance were defined as those with 1 or 2 Stars; higher star rating performance was defined by 3 to 5 Stars. Distances between two facilities were calculated based on the spherical distance between the centroids of their zip codes using the geosphere package in R.

Results

Fig. 1 shows the locations of dialysis facilities and Star category. A clear geographic pattern for distribution of lower performing facilities is not apparent. Fig. 2 demonstrates that 84% of facilities with lower star rating are within 10 miles of facilities with higher performance.

Conclusion

These results demonstrate that most patients receiving dialysis care in lower star rating facilities have the option to transfer care to higher star rating facilities based on their geographic proximity. Whether the availability of a higher star rating facility in close proximity contributes to the patient’s choice of a new or transfer facility remains unanswered by these analyses. Subsequent analyses will stratify lower and higher star rating facilities to evaluate if patients’ choice of dialysis provider is associated with higher rated facilities in close proximity.

Funding

  • Other U.S. Government Support