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Geographic disparities in mortality among the end stage renal disease patients: an analysis of the United States Renal Data System, 2007–08

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Abstract

The study was conducted to determine the association between mortality, rurality, and distance from the treatment facility of the patients with ESRD. The United States Renal Data System (USRDS) for the year 2007–08 was utilized to conduct analysis of 181,349 subjects. After adjusting for all other covariates, the odds of mortality were higher among patients in urban and isolated areas (18.1 miles or more from the dialysis facility), compared with those who were living closer (≤3.3 miles, OR 1.08, 95 % CI 1.05–1.12). Conversely, patients living in isolated rural (0–≤3.3 miles, OR 0.95, 95 % CI 0.81–0.96), small adjacent rural (8.1–≤18.1 miles, OR 0.90, 95 % CI 0.77–0.96) and Micropolitan rural quartiles (>18.1 miles, OR 0.96, 95 % CI 0.92–0.97) had lower odds of mortality than their urban counterparts. The Accountable Care Organizations must devise strategies to cater ESRD patients living in remote areas.

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Acknowledgments

This manuscript is a part of the project, which was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under the Grant number U1CRH03711, Rural Health Research Grant Program Cooperative Agreement.

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Authors and Affiliations

  1. Department of Health Policy and Management, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC, 29208, USA

    Fozia Ajmal & Janice C. Probst

  2. Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC, 29203, USA

    Kevin J. Bennett

  3. South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC, 29208, USA

    Fozia Ajmal, Kevin J. Bennett & Janice C. Probst

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  1. Fozia Ajmal
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Correspondence to Fozia Ajmal.

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We used secondary data. The study was exempted from the formal IRB review.

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We used secondary data. The study was exempted from the formal IRB review.

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Ajmal, F., Bennett, K.J. & Probst, J.C. Geographic disparities in mortality among the end stage renal disease patients: an analysis of the United States Renal Data System, 2007–08. J Nephrol 29, 817–826 (2016). https://doi.org/10.1007/s40620-016-0324-3

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  • DOI: https://doi.org/10.1007/s40620-016-0324-3

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