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Kidney Week

Abstract: PO1364

Associations Between Length of Dialysis Facility Ownership and Vascular Access

Session Information

  • Vascular Access
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Gilbertson, David T., Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Peng, Yi, Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Eggert, William, Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Krishnan, Mahesh, DaVita HealthCare Partners, Denver, Colorado, United States
Background

Length of dialysis facility ownership may be associated with facility performance in achieving guideline-recommended clinical indicators and outcomes measures. Using publicly available dialysis facility-level data, we sought to assess dialysis facility performance on 2 clinical indicators prior to and after facilities were acquired by a large dialysis organization (LDO).

Methods

Using data from Dialysis Facility Compare, we compared units that the LDO acquired during 2013 through 2016 to existing units by looking at 3 time frames: change from the year prior to acquisition, the year of acquisition, and the year following acquisition. These were compared to facilities under LDO ownership for at least 3 years and facilities not owned by the LDO. The measures assessed were percentage of patients with a catheter in use for more than 90 days and percentage of patients with an arteriovenous (AV) fistula in use.

Results

Sixty-seven units were acquired by the LDO during 2013 through 2016. Units acquired by the LDO had a higher percentage of patients with catheter use ≥90 days in the year prior to acquisition than units owned by the LDO for at least 3 years and units not owned by the LDO and improved during the year acquired and the year following acquisition (14.1%, 12.8%, 11.4%, respectively). Similar improvements were observed for AV fistula use (see Table).

Conclusion

Prior research has posited both positive and negative effects of acquisition on quality of patient care. The current results do not find negative effects and suggest possible improvements in care over the course of 1 to 2 years following acquisition, which suggests that implementation of LDO patient care protocols in newly acquired facilities may take time to unfold.

Funding

  • Commercial Support