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VOLUME 49 | NUMBER 3 | JUNE 2014


Characteristics and Performance of Minority-Serving Dialysis Facilities

Keywords: Disparities; race; dialysis facility; end-stage renal disease.

Objective: 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.

Study Design: 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.

Principal Findings: 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.

Conclusions: While minority-serving facilities generally met dialysis performance targets mandated by Medicare, they exhibited worse than expected patient survival.

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