Evidence map›Paper›PMID 32071144›Full record

ArticleCMAJ open

Association between change in physician remuneration and use of peritoneal dialysis: a population-based cohort analysis.

Aaron J Trachtenberg, Amity E Quinn, Zhihai Ma, Scott Klarenbach, Brenda Hemmelgarn, Marcello Tonelli, Peter Faris, Robert Weaver, Flora Au, Jianguo Zhang and 1 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Physician Variation and the Impact of Payment Model in Cardiac Imaging.Journal of the American Heart Association · 2023
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Aaron J TrachtenbergDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Amity E QuinnDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Zhihai MaDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Scott KlarenbachDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Brenda HemmelgarnDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Marcello TonelliDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Peter FarisDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Robert WeaverDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Flora AuDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Jianguo ZhangDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta.
Braden MannsDepartment of Internal Medicine (Trachtenberg), University of Manitoba, Winnipeg, Man.; Departments of Community Health Sciences (Quinn, Ma, Hemmelgarn, Tonelli, Faris, Weaver, Au, Zhang, Manns) and Medicine (Hemmelgarn, Tonelli, Manns), and Libin Cardiovascular Institute of Alberta and O'Brien Institute for Public Health (Hemmelgarn, Tonelli, Manns), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Alberta Health Services (Faris), Calgary, Alta. Braden.Manns@albertahealthservices.ca.
Alberta Health Services · CA

Funding

CIHR 201509FON-353640
6 · The paper itself

Abstract

backgroundHealth care payers are interested in policy-level interventions to increase peritoneal dialysis use in end-stage renal disease. We examined whether increases in physician remuneration for peritoneal dialysis were associated with greater peritoneal dialysis use.

methodsWe studied a cohort of patients in Alberta who started long-term dialysis with at least 90 days of preceding nephrologist care between Jan. 1, 2001, and Dec. 31, 2014. We compared peritoneal dialysis use 90 days after dialysis initiation in patients cared for by fee-for-service nephrologists and those cared for by salaried nephrologists before and after weekly peritoneal dialysis remuneration increased from $0 to $32 (fee change 1, Apr. 1, 2002), $49 to $71 (fee change 2, Apr. 1, 2007), and $71 to $135 (fee change 3, Apr. 1, 2009). Remuneration for peritoneal dialysis remained less than hemodialysis until fee change 3. We performed a patient-level differences-in-differences logistic regression, adjusted for demographic characteristics and comorbidities, as well as an unadjusted interrupted time-series analysis of monthly outcome data.

resultsOur cohort included 4262 patients. There was no statistical evidence of a difference in the adjusted differences-indifferences estimator following fee change 1 (0.89, 95% confidence interval [CI] 0.44-1.81), 2 (1.15, 95% CI 0.73-1.83), or 3 (1.52, 95% CI 0.96-2.40). There was no significant difference in the immediate change or the trend over time in peritoneal dialysis use between fee-for-service and salaried groups following any of the fee changes in the interrupted time-series analysis.

interpretationWe identified no statistical evidence of an increase in peritoneal dialysis use following increased fee-for-service remuneration for peritoneal dialysis. It remains unclear what role, if any, physician payment plays in selection of dialysis modality.

Indexed as

RemunerationAdultAgedAlbertaDuration of TherapyFee-for-Service PlansFemaleHumansKidney Failure, ChronicMaleMiddle AgedPeritoneal DialysisPhysiciansPopulation Surveillance

Identifiers

PMID32071144
PMCPMC7028166
OpenAlexW3008696581

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.