ArticleHealth services research2018
Market Competition and Health Outcomes in Hemodialysis.
Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed.
- Hemodialysis Facilities, Vascular Access Surgeons, and Central Venous Catheter Use: A Retrospective Cohort Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Commercial Health Insurance and Quality of Care in US Dialysis Facilities.Kidney medicine · 2025Article
- Association between hospital competition and quality of prostate cancer care.BMC health services research · 2023Article
- Medicare Advantage Plans Pay Large Markups To Consolidated Dialysis Organizations.Health affairs (Project Hope) · 2022Article
- Trends in Dialysis Industry Consolidation After Medicare Payment Reform, 2006-2016.JAMA health forum · 2021Article
- Association of Public Reporting of Medicare Dialysis Facility Quality Ratings With Access to Kidney Transplantation.JAMA network open · 2021Article
- Safety-Net Care for Maintenance Dialysis in the United States.Journal of the American Society of Nephrology : JASN · 2020Article
- Association of Hospitalization and Mortality Among Patients Initiating Dialysis With Hemodialysis Facility Ownership and Acquisitions.JAMA network open · 2019Observational
- Market Consolidation and Mortality in Patients Initiating Hemodialysis.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo examine whether market competition is associated with improved health outcomes in hemodialysis. DATA SOURCES: Secondary analysis of data from a national dialysis registry between 2001 and 2011. STUDY
designWe conducted one- and two-part linear regression models, using each hospital service area (HSA) as its own control, to examine the independent associations among market concentration and health outcomes. DATA COLLECTION: We selected cohorts of patients receiving in-center hemodialysis in the United States at the start of each calendar year. We used information about dialysis facility ownership and the location where patients received dialysis to measure an index of market concentration-the Hirschman-Herfindahl Index (HHI)-for HSA and year, which ranges from near zero (perfect competition) to one (monopoly). PRINCIPAL
findingsAn average reduction in HHI by 0.2 (one standard deviation in 2011) was associated with 2.9 fewer hospitalizations per 100 patient-years (95 percent CI, 0.4 to 5.4). If these findings were generalized to the entire in-center hemodialysis population, this would translate to 8,100 (95 percent CI 1,200 to 15,000) fewer hospitalizations in 2011. There was no association between change in market competition and mortality.
conclusionsMarket competition in dialysis may lead to improved health outcomes.
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