OBJECTIVE: To examine which factors are driving improvement in the Dialysis Facility Compare (DFC) star ratings and to test whether nonclinical facility characteristics are associated with observed longitudinal changes in the star ratings. DATA SOURCES: Data were collected from eligible patients in over 6,000 Medicare-certified dialysis facilities from three annual star rating and individual measure updates, publicly released on DFC in October 2015, October 2016, and April 2018. STUDY DESIGN: Changes in the star rating and individual quality measures were investigated across three public data releases. Year-to-year changes in the star ratings were linked to facility characteristics, adjusting for baseline differences in quality measure performance. DATA COLLECTION: Data from publicly reported quality measures, including standardized mortality, hospitalization, and transfusion ratios, dialysis adequacy, type of vascular access for dialysis, and management of mineral and bone disease, were extracted from annual DFC data releases. PRINCIPAL FINDINGS: The proportion of four- and five-star facilities increased from 30.0% to 53.4% between October 2015 and April 2018. Quality improvement was driven by the domain of care containing the dialysis adequacy and hypercalcemia measures. Additionally, independently owned facilities and facilities belonging to smaller dialysis organizations had significantly lower odds of year-to-year improvement than facilities belonging to either of the two large dialysis organizations (Odds Ratio [OR]: 0.736, 95% Confidence Interval [CI]: 0.631-0.856 and OR: 0.797, 95% CI: 0.723-0.879, respectively). CONCLUSIONS: The percentage of four- and five-star facilities has increased markedly over a three-year time period. These changes were driven by improvement in the specific quality measures that may be most directly under the control of the dialysis facility.
OBJECTIVE: To examine which factors are driving improvement in the Dialysis Facility Compare (DFC) star ratings and to test whether nonclinical facility characteristics are associated with observed longitudinal changes in the star ratings. DATA SOURCES: Data were collected from eligible patients in over 6,000 Medicare-certified dialysis facilities from three annual star rating and individual measure updates, publicly released on DFC in October 2015, October 2016, and April 2018. STUDY DESIGN: Changes in the star rating and individual quality measures were investigated across three public data releases. Year-to-year changes in the star ratings were linked to facility characteristics, adjusting for baseline differences in quality measure performance. DATA COLLECTION: Data from publicly reported quality measures, including standardized mortality, hospitalization, and transfusion ratios, dialysis adequacy, type of vascular access for dialysis, and management of mineral and bone disease, were extracted from annual DFC data releases. PRINCIPAL FINDINGS: The proportion of four- and five-star facilities increased from 30.0% to 53.4% between October 2015 and April 2018. Quality improvement was driven by the domain of care containing the dialysis adequacy and hypercalcemia measures. Additionally, independently owned facilities and facilities belonging to smaller dialysis organizations had significantly lower odds of year-to-year improvement than facilities belonging to either of the two large dialysis organizations (Odds Ratio [OR]: 0.736, 95% Confidence Interval [CI]: 0.631-0.856 and OR: 0.797, 95% CI: 0.723-0.879, respectively). CONCLUSIONS: The percentage of four- and five-star facilities has increased markedly over a three-year time period. These changes were driven by improvement in the specific quality measures that may be most directly under the control of the dialysis facility.
Authors: Daniel Brauner; Rachel M Werner; Tetyana P Shippee; John Cursio; Hari Sharma; R Tamara Konetzka Journal: Health Aff (Millwood) Date: 2018-11 Impact factor: 6.301
Authors: L A Szczech; P S Klassen; B Chua; S S Hedayati; M Flanigan; W M McClellan; D N Reddan; R A Rettig; D L Frankenfield; W F Owen Journal: Kidney Int Date: 2006-06 Impact factor: 10.612
Authors: Rajiv Saran; Bruce Robinson; Kevin C Abbott; Lawrence Y C Agodoa; Patrick Albertus; John Ayanian; Rajesh Balkrishnan; Jennifer Bragg-Gresham; Jie Cao; Joline L T Chen; Elizabeth Cope; Sai Dharmarajan; Xue Dietrich; Ashley Eckard; Paul W Eggers; Charles Gaber; Daniel Gillen; Debbie Gipson; Haoyu Gu; Susan M Hailpern; Yoshio N Hall; Yun Han; Kevin He; Paul Hebert; Margaret Helmuth; William Herman; Michael Heung; David Hutton; Steven J Jacobsen; Nan Ji; Yan Jin; Kamyar Kalantar-Zadeh; Alissa Kapke; Ronit Katz; Csaba P Kovesdy; Vivian Kurtz; Danielle Lavalee; Yi Li; Yee Lu; Keith McCullough; Miklos Z Molnar; Maria Montez-Rath; Hal Morgenstern; Qiao Mu; Purna Mukhopadhyay; Brahmajee Nallamothu; Danh V Nguyen; Keith C Norris; Ann M O'Hare; Yoshitsugu Obi; Jeffrey Pearson; Ronald Pisoni; Brett Plattner; Friedrich K Port; Praveen Potukuchi; Panduranga Rao; Kaitlyn Ratkowiak; Vanessa Ravel; Debabrata Ray; Connie M Rhee; Douglas E Schaubel; David T Selewski; Sally Shaw; Jiaxiao Shi; Monica Shieu; John J Sim; Peter Song; Melissa Soohoo; Diane Steffick; Elani Streja; Manjula Kurella Tamura; Francesca Tentori; Anca Tilea; Lan Tong; Megan Turf; Dongyu Wang; Mia Wang; Kenneth Woodside; April Wyncott; Xin Xin; Wei Zang; Lindsay Zepel; Sai Zhang; Hui Zho; Richard A Hirth; Vahakn Shahinian Journal: Am J Kidney Dis Date: 2017-03 Impact factor: 8.860
Authors: Joel T Adler; Lingwei Xiang; Joel S Weissman; James R Rodrigue; Rachel E Patzer; Sushrut S Waikar; Thomas C Tsai Journal: JAMA Netw Open Date: 2021-09-01
Authors: Stephen Salerno; Claudia Dahlerus; Joseph Messana; Karen Wisniewski; Lan Tong; Richard A Hirth; Jordan Affholter; Garrett Gremel; YiFan Wu; Ji Zhu; Jesse Roach; Elena Balovlenkov Rn; Joel Andress; Yi Li Journal: Health Serv Res Date: 2020-11-12 Impact factor: 3.734