Characteristics and performance of minority-serving dialysis facilities

Health Serv Res. 2014 Jun;49(3):971-91. doi: 10.1111/1475-6773.12144. Epub 2013 Dec 20.


Objective: To examine the structure, processes, and outcomes of American dialysis facilities that predominantly treat racial-ethnic minority patients.

Data sources/study setting: Secondary analysis of data from all patients who initiated dialysis during 2005-2008 in the United States.

Study design: In this retrospective cohort study, we examined the associations of the racial-ethnic composition of the dialysis facility with facility-level survival and achievement of performance targets for anemia and dialysis adequacy.

Data collection/extraction methods: We obtained dialysis facility- and patient-level data from the national data registry of patients with end-stage renal disease. We linked these data with clinical performance measures from the Centers for Medicare and Medicaid Services.

Principal findings: Overall, minority-serving facilities were markedly larger, more often community based, and less likely to offer home dialysis than facilities serving predominantly white patients. A significantly higher proportion of minority-serving dialysis facilities exhibited worse than expected survival as compared with facilities serving predominantly white patients (p < .001 for each). However, clinical performance measures for anemia and dialysis adequacy were similar across minority-serving status.

Conclusions: While minority-serving facilities generally met dialysis performance targets mandated by Medicare, they exhibited worse than expected patient survival.

Keywords: Disparities; dialysis facility; end-stage renal disease; race.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities / standards*
  • Ambulatory Care Facilities / statistics & numerical data*
  • Cohort Studies
  • Female
  • Humans
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Minority Groups*
  • Quality of Health Care
  • Renal Dialysis*
  • Retrospective Studies
  • United States
  • Young Adult