title: Characteristics and performance of minority-serving dialysis facilities.
abstract: OBJECTIVE
  To examine the structure, processes, and outcomes of American dialysis facilities that predominantly treat racial-ethnic minority patients.
  
  
  METHODS
  Secondary analysis of data from all patients who initiated dialysis during 2005-2008 in the United States.
  
  
  METHODS
  In this retrospective cohort study, we examined the associations of the racial-ethnic composition of the dialysis facility with facility-level survival and achievement of performance targets for anemia and dialysis adequacy.
  
  
  METHODS
  We obtained dialysis facility- and patient-level data from the national data registry of patients with end-stage renal disease. We linked these data with clinical performance measures from the Centers for Medicare and Medicaid Services.
  
  
  RESULTS
  Overall, minority-serving facilities were markedly larger, more often community based, and less likely to offer home dialysis than facilities serving predominantly white patients. A significantly higher proportion of minority-serving dialysis facilities exhibited worse than expected survival as compared with facilities serving predominantly white patients (p < .001 for each). However, clinical performance measures for anemia and dialysis adequacy were similar across minority-serving status.
  
  
  CONCLUSIONS
  While minority-serving facilities generally met dialysis performance targets mandated by Medicare, they exhibited worse than expected patient survival.
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA.
authors.forename: Yoshio N
authors.initials: YN
authors.lastname: Hall
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
authors.forename: Jonathan
authors.initials: J
authors.lastname: Himmelfarb
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards* / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D011787:Quality of Health Care; D006435:Renal Dialysis; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Disparities; dialysis facility; end-stage renal disease; race