ArticleHealth services research2006
Effect of dialysis center profit-status on patient survival: a comparison of risk-adjustment and instrumental variable approaches.
Article in Health services research, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Facility-Level Differences in Antipsychotic Drug Use: Impact on Quality Outcomes for Nursing Home Residents.Medical care · 2025Article
- The effects of hospital and dialysis unit characteristics on hospitalizations for access-related complications among children on maintenance dialysis: a European, multicenter, observational, cross-sectional study.Pediatric nephrology (Berlin, Germany) · 2023Article
- Effect of profit status in facilities on the mortality of patients on long-term haemodialysis: a nationwide cohort study.BMJ open · 2021Article
- Methodological Challenges When Studying Distance to Care as an Exposure in Health Research.American journal of epidemiology · 2019Article
- Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs.Health services research · 2018Article
- The Impact of Dementia Special Care Units on Quality of Care: An Instrumental Variables Analysis.Health services research · 2018Article
- Market Competition and Health Outcomes in Hemodialysis.Health services research · 2018Article
- Comparative Effectiveness of Surgical Options for Patients with Ductal Carcinoma In Situ: An Instrumental Variable Approach.The Permanente journal · 2018Article
- Impacts of Geographic Distance on Peritoneal Dialysis Utilization: Refining Models of Treatment Selection.Health services research · 2017Article
- Do hospital-owned skilled nursing facilities provide better post-acute care quality?Journal of health economics · 2016Article
- Matching the Genotype in Resolution: Innovative Ways of Phenotype Capture.Seminars in nephrology · 2015Review
- Confounders of mortality and hospitalization rate calculations for profit and nonprofit dialysis facilities: analytic augmentation.BMC nephrology · 2014Observational
- Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach.International journal of health care finance and economics · 2014Article
- Comparison of hospitalization rates among for-profit and nonprofit dialysis facilities.Clinical journal of the American Society of Nephrology : CJASN · 2014Article
- Midwifery care at a freestanding birth center: a safe and effective alternative to conventional maternity care.Health services research · 2013Article
- Article
- Effect of nursing home ownership on the quality of post-acute care: an instrumental variables approach.Journal of health economics · 2013Article
- The effect of dialysis chains on mortality among patients receiving hemodialysis.Health services research · 2011Article
- Reexploring differences among for-profit and nonprofit dialysis providers.Health services research · 2010Article
- Instrumental variable methods in comparative safety and effectiveness research.Pharmacoepidemiology and drug safety · 2010Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo compare the estimated effects of dialysis center profit status on patient survival using alternative estimation strategies with retrospective data. DATA SOURCES/STUDY
settingPatient and provider-level retrospective data from the United States Renal Data System (USRDS), 1996-1999. STUDY
designObservational risk adjustment and instrumental variable methods. DATA COLLECTION/EXTRACTION
methodsStudy collected measures from various USRDS files describing clinical characteristics, survival, and the profit status of the initial dialysis center for incident end-stage renal disease (ESRD) patients aged 67+. USRDS facility files were used to assess dialysis center profit status and measure patient distances to dialysis centers. PRINCIPAL
findingsFound survival effect related to profit status in the range of previous research using risk-adjusting covariates similar to those used in previous models. Adding further risk-adjusting covariates halved this effect. The relative proximity of for-profit and nonprofit dialysis centers to the patient residence was the strongest determinant of the profit status of the patient's initial dialysis center. The effect of profit status on survival was eliminated using the two-stage least squares variant of instrumental variable estimation with the relative proximity of for-profit and nonprofit dialysis centers to the patient's residence as the instrument.
conclusionsUsing only the variation in initial dialysis center profit status that was related to the relative proximity of for-profit and nonprofit dialysis centers to the patient, we found no relationship between dialysis center profit status and patient survival. These results are in contrast to results obtained using risk-adjustment methods with a limited set of risk-adjusting covariates.
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