Longitudinal analysis of market factors associated with provision of peritoneal dialysis services

Med Care Res Rev. 2011 Oct;68(5):537-58. doi: 10.1177/1077558711399768. Epub 2011 May 19.


Despite the appeal of peritoneal dialysis (PD) among patients, payers, and providers, its use in the United States has been limited and declining. Prior research has found that patient factors explain little variation in PD utilization, and little is known about the contribution of dialysis facility factors. The authors examined market factors associated with the provision of PD services in dialysis facilities between 1995 and 2003. Less than half of dialysis facilities offered PD. PD provision was not explained by disease trends or patient characteristics commonly associated with PD use. Facilities were more likely to offer PD in less competitive and less spatially concentrated markets. PD services may not be available to all patients who would benefit from it and there may be insufficient demand, economics of scale, or incentives for facilities to provide PD. These findings warrant further investigation on dialysis facilities' provision of a preferred, potentially beneficial, and cost-effective therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Health Care Sector / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Kidney Failure, Chronic / therapy
  • Longitudinal Studies
  • Peritoneal Dialysis / economics*
  • Peritoneal Dialysis / statistics & numerical data*
  • Retrospective Studies
  • United States