...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons >Dialysis facility and network factors associated with low kidney transplantation rates among United States dialysis facilities
【24h】

Dialysis facility and network factors associated with low kidney transplantation rates among United States dialysis facilities

机译：美国透析机构中与肾移植率低相关的透析机构和网络因素

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Variability in transplant rates between different dialysis units has been noted, yet little is known about facility-level factors associated with low standardized transplant ratios (STRs) across the United States End-stage Renal Disease (ESRD) Network regions. We analyzed Centers for Medicare & Medicaid Services Dialysis Facility Report data from 2007 to 2010 to examine facility-level factors associated with low STRs using multivariable mixed models. Among 4098 dialysis facilities treating 305 698 patients, there was wide variability in facility-level STRs across the 18 ESRD Networks. Four-year average STRs ranged from 0.69 (95% confidence interval [CI]: 0.64-0.73) in Network 6 (Southeastern Kidney Council) to 1.61 (95% CI: 1.47-1.76) in Network 1 (New England). Factors significantly associated with a lower STR (p-<-0.0001) included for-profit status, facilities with higher percentage black patients, patients with no health insurance and patients with diabetes. A greater number of facility staff, more transplant centers per 10 000 ESRD patients and a higher percentage of patients who were employed or utilized peritoneal dialysis were associated with higher STRs. The lowest performing dialysis facilities were in the Southeastern United States. Understanding the modifiable facility-level factors associated with low transplant rates may inform interventions to improve access to transplantation. Standardized transplant ratios vary widely among the more than 4,000 dialysis facilities in the United States, and facilities with the lowest rates are located in the Southeast. Also see viewpoint by Patzer and Pastan (page 1499) and counterpoint by Srinivas (page 1506).
机译：已经注意到了不同透析单位之间移植率的差异，但是对于整个美国终末期肾脏病（ESRD）网络区域中与低标准移植率（STR）相关的设施水平因素知之甚少。我们分析了2007年至2010年的医疗保险和医疗补助服务中心透析设施报告数据，以使用多变量混合模型检查与低STR关联的设施水平因素。在用于305 698名患者的4098个透析设施中，在18个ESRD网络中，设施级STR的差异很大。四年平均STR介于网络6（东南肾脏理事会）的0.69（95％置信区间[CI]：0.64-0.73）和网络1（新英格兰）的1.61（95％CI：1.47-1.76）之间。与较低STR（p-<-0.0001）显着相关的因素包括营利性状态，黑人患者百分比较高的机构，没有健康保险的患者和糖尿病患者。设施人员更多，每万名ESRD患者中有更多的移植中心，以及接受或利用腹膜透析的患者比例较高，这与较高的STR相关。透析设备性能最低的是美国东南部。了解与低移植率相关的可修改的设施水平因素可能会为干预措施提供信息，以改善获得移植的机会。在美国的4,000多个透析设施中，标准化的移植率差异很大，而东南部的比率最低。另请参见Patzer和Pastan的观点（第1499页）和Srinivas的观点（第1506页）。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号