ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2019
Market Consolidation and Mortality in Patients Initiating Hemodialysis.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Commercial Health Insurance and Quality of Care in US Dialysis Facilities.Kidney medicine · 2025Article
- Dialysis Facility Participation In Medicare Advantage Networks Was Highest For Large Dialysis Organizations In 2021.Health affairs (Project Hope) · 2025Article
- Article
- Trends in Dialysis Industry Consolidation After Medicare Payment Reform, 2006-2016.JAMA health forum · 2021Article
- The dialysis facility levels and sizes are associated with outcomes of incident hemodialysis patients.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundIt is uncertain whether consolidation in health care markets affects the quality of care provided and health outcomes.
objectivesTo examine whether changes in market competition resulting from acquisitions by two large national for-profit dialysis chains were associated with patient mortality.
methodsWe identified patients initiating in-center hemodialysis between 2001 and 2009 from a registry of patients with end-stage renal disease in the United States. We considered two scenarios when evaluating consolidation from dialysis facility acquisitions: one in which we considered only those patients receiving dialysis in markets that became substantially more concentrated to have been affected by consolidation, and the other in which all patients living in hospital service areas where a facility was acquired were potentially affected. We used a difference-in-differences study design to examine the associations between market consolidation and changes in mortality rates.
resultsWhen we considered the 12,065 patients living in areas that became substantially more consolidated to have been affected by consolidation, we found a nominally significant (8%; 95% confidence interval 0%-17%) increase in likelihood of death after consolidation. Nevertheless, when we considered all 186,158 patients living in areas where an acquisition occurred to have been affected by consolidation, there was no observable effect of market consolidation on mortality.
conclusionsDecreased market competition may have led to increased mortality among a relatively small subset of patients initiating in-center hemodialysis in areas that became substantially more concentrated after two large dialysis acquisitions, but not for most of the patients living in affected areas.
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