Area-level poverty, race/ethnicity & dialysis star ratings

Abhijit V. Kshirsagar, Raj N. Manickam, Yi Mu, Jennifer E. Flythe, Andrew I Chin, Heejung Bang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The Centers for Medicare and Medicaid Services recently released a five star rating system as part of ‘Dialysis Facility Compare’ to help patients identify and choose high performing clinics in the US. Eight dialysis-related measures determine ratings. Little is known about the association between surrounding community sociodemographic characteristics and star ratings. Using data from the U.S. Census and over 6000 dialysis clinics across the country, we examined the association between dialysis clinic star ratings and characteristics of the local population: 1) proportion of population below the federal poverty level (FPL); 2) proportion of black individuals; and 3) proportion of Hispanic individuals, by correlation and regression analyses. Secondary analyses with Quality Incentive Program (QIP) scores and population characteristics were also performed. We observed a negligible correlation between star ratings and the proportion of local individuals below FPL; Spearman coefficient, R = -0.09 (p<0.0001), and a stronger correlation between star ratings and the proportion of black individuals; R = -0.21 (p<0.0001). Ordered logistic regression analyses yielded adjusted odds ratio of 0.91 (95% confidence interval [0.80–1.30], p = 0.12) and 0.55 ([0.48–0.63], p<0.0001) for high vs. low level of proportion below FPL and proportion of black individuals, respectively. In contrast, a near-zero correlation was observed between star ratings and the proportion of Hispanic individuals. Correlations varied substantially by country region, clinic profit status and clinic size. Analyses using clinic QIP scores provided similar results. Sociodemographic characteristics of the surrounding community, factors typically outside of providers’ direct control, have varying levels of association with clinic dialysis star ratings.

Original languageEnglish (US)
Article numbere0186651
JournalPLoS One
Volume12
Issue number10
DOIs
StatePublished - Oct 1 2017

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Poverty Areas
Dialysis
dialysis
poverty
nationalities and ethnic groups
Stars
Poverty
sociodemographic characteristics
Population Characteristics
Hispanic Americans
Motivation
Regression Analysis
Centers for Medicare and Medicaid Services (U.S.)
population characteristics
Censuses
odds ratio
profits and margins
confidence interval
Logistic Models
Odds Ratio

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kshirsagar, A. V., Manickam, R. N., Mu, Y., Flythe, J. E., Chin, A. I., & Bang, H. (2017). Area-level poverty, race/ethnicity & dialysis star ratings. PLoS One, 12(10), [e0186651]. https://doi.org/10.1371/journal.pone.0186651

Area-level poverty, race/ethnicity & dialysis star ratings. / Kshirsagar, Abhijit V.; Manickam, Raj N.; Mu, Yi; Flythe, Jennifer E.; Chin, Andrew I; Bang, Heejung.

In: PLoS One, Vol. 12, No. 10, e0186651, 01.10.2017.

Research output: Contribution to journalArticle

Kshirsagar, AV, Manickam, RN, Mu, Y, Flythe, JE, Chin, AI & Bang, H 2017, 'Area-level poverty, race/ethnicity & dialysis star ratings', PLoS One, vol. 12, no. 10, e0186651. https://doi.org/10.1371/journal.pone.0186651
Kshirsagar, Abhijit V. ; Manickam, Raj N. ; Mu, Yi ; Flythe, Jennifer E. ; Chin, Andrew I ; Bang, Heejung. / Area-level poverty, race/ethnicity & dialysis star ratings. In: PLoS One. 2017 ; Vol. 12, No. 10.
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