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Physician access and early nephrology care in elderly patients with end-stage renal disease
Journal article   Open access   Peer reviewed

Physician access and early nephrology care in elderly patients with end-stage renal disease

Yongming Zhao, John M Brooks, Michael J Flanigan, Elizabeth A Chrischilles, Jane F Pendergast and Lawrence G Hunsicker
Kidney international, Vol.74(12), pp.1596-1602
12/02/2008
DOI: 10.1038/ki.2008.212
PMID: 18509317
url
https://doi.org/10.1038/ki.2008.212View
Published (Version of record) Open Access

Abstract

Early nephrology care may improve treatment outcomes of patients with end-stage renal disease. We sought to examine if physician access affects early nephrology care defined as visiting a nephrologist 12 to 4 months before initiating dialysis. The study population consisted of elderly patients starting hemodialysis whose demographic characteristics and initial dialysis therapy were derived from form 2728 files of the Centers for Medicare & Medicaid Services. Early nephrology care, chronic kidney disease and co-morbidities along with access to local non-nephrologist physicians and nephrologists were identified based on Medicare claims and/or United States 2000 Census data. About one-third of elderly patients received early nephrology care prior to initiating dialysis. Patients living in an area with a large number of non-nephrologist physicians or living relatively far away from a nephrologist had a lower likelihood of getting early nephrology care prior to initiating dialysis while those in an area with more practicing nephrologists were more likely to get early nephrology care. The study shows that physician access significantly influences the use of early nephrology care among elderly patients progressing to end-stage renal disease in the United States.
 Hemodialysis predialysis care physician access early nephrology care end-stage renal disease early referral

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