ArticleJournal of the American Society of Nephrology : JASN2015
Provider Visits and Early Vascular Access Placement in Maintenance Hemodialysis.
Article in Journal of the American Society of Nephrology : JASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 22 citations in OpenAlex.
- Article
- Utilization of Telemedicine for Patients Receiving In-Center Hemodialysis in the United States.Journal of the American Society of Nephrology : JASN · 2025Article
- Patient Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Study.Kidney medicine · 2024Article
- Update on the creation and maintenance of arteriovenous fistulas for haemodialysis in children.Pediatric nephrology (Berlin, Germany) · 2021Review
- Are There Differences in Arteriovenous Fistulae Created for Hemodialysis between Nephrologists and Vascular Surgeons?Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2021Article
- Hemodialysis vascular access and subsequent transplantation: a report from the ESPN/ERA-EDTA Registry.Pediatric nephrology (Berlin, Germany) · 2019Article
- Article
- Evaluating the Evidence behind Policy Mandates in US Dialysis Care.Journal of the American Society of Nephrology : JASN · 2018Article
- Arteriovenous Fistula Maturation in Prevalent Hemodialysis Patients in the United States: A National Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Observational
- Hemodialysis Hospitalizations and Readmissions: The Effects of Payment Reform.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2017Article
- Effects of physician payment reform on provision of home dialysis.The American journal of managed care · 2016Article
- Outpatient Dialysis for Patients with AKI: A Policy Approach to Improving Care.Clinical journal of the American Society of Nephrology : CJASN · 2015Review
- The impact of Vascular Access on the Adequacy of Dialysis and the Outcome of the Dialysis Treatment: One Center Experience.Materia socio-medica · 2015Article
- Patient Satisfaction Is Associated With Dialysis Facility Quality and Star Ratings.American journal of medical quality : the official journal of the American College of Medical QualityArticle
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
Medicare reimbursement policy encourages frequent provider visits for patients with ESRD undergoing hemodialysis. We hypothesize that patients seen more frequently by their nephrologist or advanced practitioner within the first 90 days of hemodialysis are more likely to undergo surgery to create an arteriovenous (AV) fistula or place an AV graft. We selected 35,959 patients aged ≥67 years starting hemodialysis in the United States from a national registry. We used multivariable regression to evaluate the associations between mean visit frequency and AV fistula creation or graft placement in the first 90 days of hemodialysis. We conducted an instrumental variable analysis to test the sensitivity of our findings to potential bias from unobserved characteristics. One additional visit per month in the first 90 days of hemodialysis was associated with a 21% increase in the odds of AV fistula creation or graft placement during that period (95% confidence interval, 19% to 24%), corresponding to an average 4.5% increase in absolute probability. An instrumental variable analysis demonstrated similar findings. Excluding visits in months when patients were hospitalized, one additional visit per month was associated with a 10% increase in odds of vascular access surgery (95% confidence interval, 8% to 13%). In conclusion, patients seen more frequently by care providers in the first 90 days of hemodialysis undergo earlier AV fistula creation or graft placement. Payment policies that encourage more frequent visits to patients at key clinical time points may yield more favorable health outcomes than policies that operate irrespective of patients' health status.
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