Association of U.S. Dialysis facility neighborhood characteristics with facility-level kidney transplantation.
Association of U.S. Dialysis facility neighborhood characteristics with facility-level kidney transplantation.
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DOI：
10.1159/000365596
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发表时间：
2014
影响因子：
4.2
通讯作者：
Patzer RE
中科院分区：
文献类型：
--
作者：
Plantinga L;Pastan S;Kramer M;McClellan A;Krisher J;Patzer RE
改善获得最佳医疗保健的机会可能取决于患者接受医疗保健服务的社区的属性。我们调查了透析设施周边的特点--大多数终末期肾病患者接受治疗的地方--是否与设施水平的肾移植相关。我们在3,983家美国透析机构中研究了人口普查区（社区）水平的社会人口因素与机构水平的肾移植率之间的关系，这些透析机构报告了肾移植率。从透析机构报告中获得2007-2010年机构层面的肾移植数量和总人-年，并将其与2006-2010年美国社区调查中透析机构位置的社会人口统计学特征的人口普查数据相关联。我们使用多变量Poisson模型和广义估计方程来估计邻域特征和移植发生率之间的关联。美国的透析设施位于黑人和贫困居民比例相对于全国平均水平更高的社区。大多数设施社区特征与移植相关，标准化增量的发生率比（95%CI）（百分比）邻里接触：生活贫困，0.88（0.84-0.92），黑人，0.83（0.78-0.89）;高中毕业生，1.22（1.17-1.26）;失业者，0.90（0.85-0.95）。透析设施附近的特点可能与肾移植的设施率适度相关。改善肾移植机会的透析设施干预措施的成功可能部分取决于减少社区层面的障碍。
Improving access to optimal healthcare may depend on attributes of neighborhoods where patients receive healthcare services. We investigated whether characteristics of dialysis facility neighborhoods—where most patients with end-stage renal disease are treated—were associated with facility-level kidney transplantation. We examined the association between census tract (neighborhood)-level sociodemographic factors and facility-level kidney transplantation rate in 3,983 U.S. dialysis facilities with reported kidney transplantation rates. Number of kidney transplants and total person-years contributed at the facility level in 2007-2010 were obtained from the Dialysis Facility Report and linked to census tract data on sociodemographic characteristics from the American Community Survey 2006-2010 by dialysis facility location. We used multivariable Poisson models with generalized estimating equations to estimate associations between neighborhood characteristics and transplant incidence. U.S. dialysis facilities were located in neighborhoods with substantially greater proportions of black and poor residents, relative to the national average. Most facility neighborhood characteristics were associated with transplant, with incidence rate ratios (95% CI) for standardized increments (in percentage) of neighborhood exposures of: living in poverty, 0.88 (0.84-0.92), black race, 0.83 (0.78-0.89); high school graduates, 1.22 (1.17-1.26); and unemployed, 0.90 (0.85-0.95). Dialysis facility neighborhood characteristics may be modestly associated with facility rates of kidney transplantation. The success of dialysis facility interventions to improve access to kidney transplantation may partially depend on reducing neighborhood-level barriers.
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影响因子：
158.5
作者：
EVANS, RW;MANNINEN, DL;LOWRIE, EG
通讯作者：
LOWRIE, EG
影响因子：
8.8
作者：
Patzer, R. E.;Sayed, B. A.;Amaral, S.
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影响因子：
5.5
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通讯作者：
Roux, AVD
影响因子：
13.6
作者：
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通讯作者：
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影响因子：
120.7
作者：
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通讯作者：
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