TY - JOUR
T1 - Treatment Bias in the Management of End-Stage Renal Disease
AU - Smith, Marc D.
AU - Hong, Barry A.
AU - Michelman, Jeffrey E.
AU - Robson, Alan M.
N1 - Funding Information:
From the Health Administration and Planning Program and the Departments of Psychiatry and Pediatrics, Washington University School of Medicine, St Louis, Mo; The Jewish Hospital of St Louis, St Louis, Mo; and Division of Pediatric Nephrology, St Louis Children's Hospital, St Louis, Mo. Address reprint requests to Marc D. Smith, PhD, Assistant Professor, Health Administration and Planning Program. Washington University School of Medicine, 4547 Clayton Avenue, St Louis, MO 63110. This research was supported by a grant from the Missouri Kidney Program. © 1983 by The National Kidney Foundation, Inc. 0272-6386/83/01021-06$01.00/0
PY - 1983
Y1 - 1983
N2 - A study was conducted of 419 patients with end-stage renal disease (ESRD) being treated by center or home hemodialysis or by renal transplantation at four facilities located within 2.5 km of each other. The objectives were to examine the distribution of patients among the three modes of treatment and to analyze patient transfers to alternate modes of ESRD therapy. While white patients at each facility were comparable (P 〉 0.05) on age, sex, travel time to treatment, marital status, work or employment status, and the presence of diabetes mellitus, the distribution of patients among the treatment modes differed significantly (P < 0.001) across the facilities. Similarly, the sociodemographic and diagnostic characteristics of the nonwhite patients were comparable at each of the facilities (P 〉 0.05); however, despite observable variation among the facilities in the distribution of these patients, the differences did not achieve statistical significance (P 〉 0.05). Patient transfers to alternate modes of ESRD therapy were infrequent, and among center hemodialysis patients, the distribution of transfers differed significantly across the facilities (P < 0.001). It is concluded that the distribution of patients was dependent on the patient's initial mode of therapy and the staff attitudes at the individual facilities.
AB - A study was conducted of 419 patients with end-stage renal disease (ESRD) being treated by center or home hemodialysis or by renal transplantation at four facilities located within 2.5 km of each other. The objectives were to examine the distribution of patients among the three modes of treatment and to analyze patient transfers to alternate modes of ESRD therapy. While white patients at each facility were comparable (P 〉 0.05) on age, sex, travel time to treatment, marital status, work or employment status, and the presence of diabetes mellitus, the distribution of patients among the treatment modes differed significantly (P < 0.001) across the facilities. Similarly, the sociodemographic and diagnostic characteristics of the nonwhite patients were comparable at each of the facilities (P 〉 0.05); however, despite observable variation among the facilities in the distribution of these patients, the differences did not achieve statistical significance (P 〉 0.05). Patient transfers to alternate modes of ESRD therapy were infrequent, and among center hemodialysis patients, the distribution of transfers differed significantly across the facilities (P < 0.001). It is concluded that the distribution of patients was dependent on the patient's initial mode of therapy and the staff attitudes at the individual facilities.
KW - ESRD
KW - hemodialysis
KW - transplantation
UR - http://www.scopus.com/inward/record.url?scp=0020963795&partnerID=8YFLogxK
U2 - 10.1016/S0272-6386(83)80005-5
DO - 10.1016/S0272-6386(83)80005-5
M3 - Article
C2 - 6346863
AN - SCOPUS:0020963795
SN - 0272-6386
VL - 3
SP - 21
EP - 26
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -