Geographic disparities in mortality among the end stage renal disease patients: an analysis of the United States Renal Data System, 2007-08.

The study was conducted to determine the association between mortality, rurality, and distance from the treatment facility of the patients with ESRD. The United States Renal Data System (USRDS) for the year 2007-08 was utilized to conduct analysis of 181,349 subjects. After adjusting for all other covariates, the odds of mortality were higher among patients in urban and isolated areas (18.1 miles or more from the dialysis facility), compared with those who were living closer (≤3.3 miles, OR 1.08, 95 % CI 1.05-1.12). Conversely, patients living in isolated rural (0-≤3.3 miles, OR 0.95, 95 % CI 0.81-0.96), small adjacent rural (8.1-≤18.1 miles, OR 0.90, 95 % CI 0.77-0.96) and Micropolitan rural quartiles (>18.1 miles, OR 0.96, 95 % CI 0.92-0.97) had lower odds of mortality than their urban counterparts. The Accountable Care Organizations must devise strategies to cater ESRD patients living in remote areas.