Dialysis Facility Characteristics and Variation in Employment Rates: A National Study
Open accessAbstract
BACKGROUND: Investigation of factors associated with variation in dialysis patient employment has focused primarily on patient-level factors. Little is known about facility-level factors that may be associated with patient employment. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The ESRD Facility Survey (CMS-2744A) began in 2004 to collect counts of employed patients aged 18 to 54, in addition to dialysis unit census, types and timing of treatments offered, and staffing. Using the 2004 ESRD Facility Survey File, we investigated dialysis unit characteristics and facility employment rate of patients aged 18 to 54 in a logistic regression analysis that included hospital-based chronic renal care facilities, nonhospital renal disease treatment centers, independent special purpose renal dialysis facilities, and renal disease treatment centers. RESULTS: Across all facilities, 18.9% of prevalent patients aged 18 to 54 were employed, but facility employment rates ranged from 0 to 100%. Facility employment rate was positively associated independently with availability of a 5 p.m. or later dialysis shift (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.42 to 1.68), availability of peritoneal dialysis or home hemodialysis (HD) training (OR 1.19, 95% CI 1.11 to 1.28), and provision of frequent HD (OR 1.26, 95% CI 1.07 to 1.49), after adjusting for patient/social worker ratio, rurality of unit location, and unit size. In addition, patient receipt of Vocational Rehabilitation (VR) services was more often reported in facilities with higher employment rates. CONCLUSIONS: Promoting gainful employment among ESRD patients continues to be a quality improvement need. A dataset that allows adjustment for patient-level variables would facilitate increased understanding of the contribution of dialysis facility variables to patient employment.
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Nearly one quarter of ESRD patients stop dialysis before they die.
“almost 25% of patients with ESRD choose to discontinue dialysis before death [4].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [4]
In the United States, people over 75 have higher ESRD incidence than younger people and are the fastest-growing ESRD group.
“Today, patients over the age of 75 have higher incidence rates of ESRD than younger patients and constitute the fastest growing segment of the ESRD population in the United States [4].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [4]
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- Authors
- Kutner, N., Bowles, T., Zhang, R., Huang, Y., & Pastan, S.
- Affiliations
- Emory University (US)
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2008-01
- Volume
- 3
- Issue
- 1
- Pages
- 111-116
- ISSN
- 1555-9041 (ISSN-L)
- PMC
- PMC2390987
- OpenAlex
- W2149014784
- Cited by
- 77
- References
- 15
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 6 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 4
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Society of Nephrology
- National Institutes of Health
- U.S. Public Health Service (HHSN267200715004C)
- National Institute of Diabetes and Digestive and Kidney Diseases (N01-DK-7-5004, N01 DK 12471, HHSN267200715004C)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Safety Research › Disability Education and Employment
- Keywords
- end-stage renal disease, peritoneal dialysis, home hemodialysis, vocational rehabilitation, facility-level variation, quality improvement
- MeSH terms
- Adolescent, Adult, Ambulatory Care Facilities, Data Collection, Employment, Renal Dialysis, Humans, Kidney Failure, Chronic, Middle Aged, Rehabilitation, Vocational, Social Work, United States, Prevalence, Multivariate Analysis, Logistic Models, Databases, Factual
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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