Dialysis modality selection among patients attending freestanding dialysis facilities.
Date of Pub
Persons with end stage renal disease (ESRD) are eligible to receive dialysis services under the Medicare program. An individual-level
analysis was performed to determine the factors associated with the modality selected by patients; namely in-center hemodialysis,
continuous ambulatory peritoneal dialysis (CAPD), continuous cycling peritoneal dialysis (CCPD), and home hemodialysis. Logistic
regression equations were estimated using program data for 73,448 ESRD Medicare patients attending freestanding dialysis facilities.
The results showed that CAPD, CCPD, and home hemodialysis were more likely to be selected by patients who were younger, had
non-systemic precipitating causes of ESRD, had a shorter duration of ESRD, attended larger facilities, and were not ethnic
minorities. There is no consistent evidence demonstrating the superiority of particular modalities. The policy goal should
be to enable beneficiaries to use the modality for which they are best suited, which requires that the range of modalities
be available to all ESRD beneficiaries.
Adult : Aged : Ambulatory Care Facilities/utilization : Choice Behavior : Demography : Female : Health Policy : Hemodialysis,
Home/utilization : Hemodialysis/methods/utilization : Human : Kidney Failure, Chronic/therapy : Logistic Models : Male : Medicare
: Middle Age : Patient Acceptance of Health Care/statistics & numerical data : Peritoneal Dialysis, Continuous Ambulatory/utilization
: Regression Analysis : United States