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Zhang Q, Thamer M, Kshirsagar O, et al. Impact of the End Stage Renal Disease Prospective Payment System on the Use of Peritoneal Dialysis. Kidney Int Rep. 2016;2(3):350-358doi: 10.1016/j.ekir.2016.12.004.
Zhang, Q., Thamer, M., Kshirsagar, O., & Zhang, Y. (2017). Impact of the End Stage Renal Disease Prospective Payment System on the Use of Peritoneal Dialysis. Kidney international reports, 2(3), 350-358. https://doi.org/10.1016/j.ekir.2016.12.004
Zhang, Qian, et al. "Impact of the End Stage Renal Disease Prospective Payment System on the Use of Peritoneal Dialysis." Kidney international reports vol. 2,3 (2017): 350-358. doi: https://doi.org/10.1016/j.ekir.2016.12.004
Zhang Q, Thamer M, Kshirsagar O, Zhang Y. Impact of the End Stage Renal Disease Prospective Payment System on the Use of Peritoneal Dialysis. Kidney Int Rep. 2016 Dec 20;2(3):350-358. doi: 10.1016/j.ekir.2016.12.004. eCollection 2017 May. PMID: 29142964; PMCID: PMC5678611.
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Kidney Int Rep. 2016 Dec 20;2(3):350-358. doi: 10.1016/j.ekir.2016.12.004. eCollection 2017 May.

Impact of the End Stage Renal Disease Prospective Payment System on the Use of Peritoneal Dialysis.

Kidney international reports

Qian Zhang, Mae Thamer, Onkar Kshirsagar, Yi Zhang

Affiliations

  1. Medical Technology and Practice Patterns Institute, Bethesda, Maryland, USA.

PMID: 29142964 PMCID: PMC5678611 DOI: 10.1016/j.ekir.2016.12.004

Abstract

INTRODUCTION: The End Stage Renal Disease (ESRD) Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services in January 2011, encouraged use of peritoneal dialysis (PD) through various financial incentives. Our goal was to determine whether PPS effectively increased PD use in incident dialysis patients.

METHODS: Our study used the United States Renal Data System (USRDS) to identify 430,927 adult patients who initiated dialysis between 2009 and 2012. The interrupted time series method was used to evaluate the association Centers for Medicare and Medicaid Services of PPS with PD use at dialysis initiation. We further stratified by patient demographics, predialysis care, and facility chain and profit status.

RESULTS: Interrupted time series analysis indicated PPS was associated with increased PD use in the 2-year period after PPS (change in slope = 0.04,

DISCUSSION: Implementation of the Centers for Medicare and Medicaid Services ESRD payment reform was associated with an increased use of PD in the 2 years after PPS. Our findings highlight the role of financial incentives in changing practice patterns to increase use of a dialysis modality considered to be both more cost-effective and empowering to ESRD patients. However, even after PPS, rates of PD use remain low among the dialysis population in the USA.

Keywords: end-stage renal disease; interrupted time series; peritoneal dialysis; prospective payment system

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