Growing demand for dialysis exceeds its supply and travel distances prohibit many Veterans from receiving dialysis in a facility, leading to increased use of dialysis from non‐ providers. This study compared utilization and hospitalization outcomes among Veterans receiving chronic dialysis in and non‐ settings in 2008–2013.
, Medicare, and national disease registry data.
National cohort of 27,301 Veterans initiating dialysis, observed for a period of 2 years after treatment initiation. We used multinomial logistic regression to examine associations between patient characteristics and dialysis use in , non‐ community settings via Purchased Care (‐), community settings via Medicare, or Dual settings. Zero‐inflated negative binomial regression was used to compare risk of hospitalization and days spent in the hospital across dialysis settings.
Sixty‐seven percent of Veterans obtained community‐based dialysis exclusively via Medicare, 11 percent in the community via ‐, 4 percent in , and 18 percent in Dual settings. Financial and geographic access factors were important predictors of dialysis setting, but days spent in the hospital and risk of hospitalization did not differ meaningfully across settings.
Most Veterans obtained dialysis in the community. Dialysis setting appeared to have little impact on risk of hospitalization among Veterans.