Table 2.
Crude and adjusted odds ratios for dichotomous ESRD quality-of-care indicators (pre-ESRD care, knowledge of transplant options, and permanent hemodialysis vascular access) by sociodemographic factor, among US patients in whom treatment for ESRD attributed to lupus nephritis was initiated between July 1, 2005 and September 30, 2011*
| Patient received pre-ESRD nephrology care | Patient informed of transplant options | Fistula/graft used or in place at first dialysis | |||||||
|---|---|---|---|---|---|---|---|---|---|
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| Crude % | Odds ratio (95% CI) | Crude % | Odds ratio (95% CI) | Crude % | Odds ratio (95% CI) | ||||
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| Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | ||||
| Overall | 71.1 | – | – | 84.8 | – | – | 24.4 | – | – |
| Individual sociodemographic factors† | |||||||||
| Race/ethnicity, % | |||||||||
| White | 76.7 | 1.00 (ref.) | 1.00 (ref.) | 84.0 | 1.00 (ref.) | 1.00 (ref.) | 28.2 | 1.00 (ref.) | 1.00 (ref.) |
| Black | 69.1 | 0.68 (0.59–0.79) | 0.73 (0.63–0.85) | 85.4 | 1.21 (0.99–1.48) | 1.07 (0.88–1.30) | 24.1 | 0.81 (0.70–0.94) | 0.96 (0.81–1.12) |
| Hispanic | 67.1 | 0.61 (0.52–0.73) | 0.73 (0.60–0.88) | 83.9 | 1.02 (0.80–1.31) | 0.95 (0.75–1.20) | 20.5 | 0.65 (0.54–0.80) | 0.85 (0.69–1.05) |
| Other | 74.8 | 0.90 (0.70–1.14) | 0.95 (0.74–1.22) | 84.8 | 1.15 (0.83–1.61) | 0.99 (0.72–1.35) | 24.4 | 0.83 (0.64–1.07) | 1.06 (0.81–1.38) |
| Insurance, % | |||||||||
| Private | 78.4 | 1.00 (ref.) | 1.00 (ref.) | 87.6 | 1.00 (ref.) | 1.00 (ref.) | 25.3 | 1.00 (ref.) | 1.00 (ref.) |
| Medicare/other‡ | 73.4 | 0.77 (0.65–0.91) | 0.76 (0.63–0.90) | 82.8 | 0.66 (0.51–0.85) | 0.61 (0.47–0.80) | 28.5 | 1.18 (0.99–1.10) | 1.03 (0.86–1.23) |
| Medicaid | 69.3 | 0.62 (0.54–0.72) | 0.64 (0.56–0.74) | 83.4 | 0.71 (0.59–0.87) | 0.66 (0.54–0.80) | 24.4 | 0.95 (0.82–1.10) | 1.05 (0.91–1.22) |
| None | 47.5 | 0.25 (0.21–0.30) | 0.26 (0.21–0.31) | 83.4 | 0.65 (0.51–0.83) | 0.68 (0.54–0.87) | 16.0 | 0.55 (0.43–0.69) | 0.62 (0.49–0.79) |
| Residential neighborhood (ZCTA) sociodemographic factors§ | |||||||||
| % black | |||||||||
| Below median | 73.4 | 1.00 (ref.) | 1.00 (ref.) | 84.2 | 1.00 (ref.) | 1.00 (ref.) | 24.6 | 1.00 (ref.) | 1.00 (ref.) |
| Above median | 68.9 | 0.81 (0.72–0.91) | 0.95 (0.82–1.09) | 85.4 | 1.09 (0.94–1.26) | 1.04 (0.87–1.25) | 24.2 | 0.97 (0.86–1.10) | 1.01 (0.86–1.18) |
| % Hispanic | |||||||||
| Below median | 73.4 | 1.00 (ref.) | 1.00 (ref.) | 84.5 | 1.00 (ref.) | 1.00 (ref.) | 25.2 | 1.00 (ref.) | 1.00 (ref.) |
| Above median | 68.9 | 0.81 (0.72–0.91) | 0.83 (0.73–0.95) | 85.2 | 1.06 (0.91–1.23) | 1.05 (0.91–1.23) | 23.6 | 0.92 (0.81–1.04) | 0.99 (0.87–1.12) |
| % dropped out of high school | |||||||||
| Below median | 74.0 | 1.00 (ref.) | 1.00 (ref.) | 85.8 | 1.00 (ref.) | 1.00 (ref.) | 25.0 | 1.00 (ref.) | 1.00 (ref.) |
| Above median | 68.3 | 0.76 (0.68–0.85) | 0.89 (0.79–1.01) | 83.9 | 0.85 (0.73–0.98) | 0.87 (0.74–1.02) | 23.9 | 0.93 (0.83–1.06) | 1.01 (0.88–1.15) |
| % with income below poverty level | |||||||||
| Below median | 74.6 | 1.00 (ref.) | 1.00 (ref.) | 85.3 | 1.00 (ref.) | 1.00 (ref.) | 25.9 | 1.00 (ref.) | 1.00 (ref.) |
| Above median | 67.7 | 0.72 (0.64–0.81) | 0.84 (0.74–0.95) | 84.3 | 0.91 (0.79–1.06) | 0.93 (0.79–1.09) | 23.0 | 0.85 (0.75–0.96) | 0.88 (0.77–1.00) |
Adjusted models (complete case analysis) include age, race/ethnicity, insurance, body mass index (≥35 kg/m2 versus <35 kg/m2), hypertension, and cardiovascular disease. ref. = referent; ZCTA = ZIP code tabulation area.
Numbers of patients in the assessment of crude percent and in the assessment of odds ratio (95% confidence interval [95% CI]), respectively, were 5,939 and 5,875 for pre–end-stage renal disease (pre-ESRD) nephrology care, 5,619 and 5,558 for patient informed of transplant options, and 5,624 and 5,562 for fistula/graft used or in place at first dialysis.
Includes Medicare, VA, and other.
Numbers of patients in the assessment of crude percent and in the assessment of odds ratio (95% CI), respectively, were 5,810 and 5,746 for pre-ESRD nephrology care, 5,492 and 5,431 for patient informed of transplant options, and 5,500 and 5,438 for fistula/graft used or in place at first dialysis.