Table 1.
Distribution of individual- and neighborhood-level study variables stratified by hospitalization rate among patients with continuous Medicare coverage waitlisted for kidney transplant in the United States, 2005–2013.
| Variable | Overall | Hospitalizations/year | p value | ||
|---|---|---|---|---|---|
| 0 | 0< and <=2 | >2 | |||
|
|
|||||
| n=53 810 | N=22 322 | N=22 058 | N=9430 | ||
| Age at Waitlisting (Mean, SD) | 54.5 (13.22) | 53.9 (13.66) | 54.7 (12.93) | 55.5 (12.75) | <0.001 |
| Female | 20 449 (38.00) | 7901 (35.40) | 8638 (39.16) | 3910 (41.46) | <0.001 |
| Race/Ethnicity | |||||
| Asian | 2714 (5.04) | 1213 (5.43) | 1205 (5.46) | 296 (3.14) | <0.001 |
| Black Hispanic | 199 (0.37) | 71 (0.32) | 83 (0.38) | 45 (0.48) | |
| Black nonHispanic | 17 467 (32.46) | 6678 (29.92) | 7731 (35.05) | 3058 (32.43) | |
| Other | 863 (1.6) | 337 (1.51) | 402 (1.82) | 124 (1.31) | |
| White Hispanic | 9925 (18.44) | 3885 (17.40) | 4477 (20.3) | 1563 (16.57) | |
| White nonHispanic | 22 642 (42.08) | 10 138 (45.42) | 8160 (36.99) | 4344 (46.07) | |
| Blood type | |||||
| A | 17 628 (32.76) | 8002 (35.85) | 6562 (29.75) | 3064 (32.49) | <0.001 |
| B | 7893 (14.67) | 3067 (13.74) | 3430 (15.55) | 1396 (14.8) | |
| AB | 2176 (4.04) | 1119 (5.01) | 693 (3.14) | 364 (3.86) | |
| O | 26 113 (48.53) | 10 134 (45.4) | 11 373 (51.56) | 4606 (48.84) | |
| BMI | |||||
| Underweight | 1838 (3.42) | 789 (3.53) | 702 (3.18) | 347 (3.68) | <0.001 |
| Normal weight | 14 140 (26.28) | 6102 (27.34) | 5553 (25.17) | 2485 (26.35) | |
| Overweight | 16 702 (31.04) | 7029 (31.49) | 6799 (30.82) | 2874 (30.48) | |
| Obese | 21 130 (39.27) | 8402 (37.64) | 9004 (40.82) | 3724 (39.49) | |
| ESRD/CKD Cause | |||||
| Diabetes | 23 580 (43.82) | 8466 (37.93) | 10 117 (45.87) | 4997 (52.99) | <0.001 |
| Hypertension | 13 609 (25.29) | 6097 (27.31) | 5595 (25.36) | 1917 (20.33) | |
| Kidney-related | 10 277 (19.10) | 4888 (21.90) | 3990 (18.09) | 1399 (14.84) | |
| Other | 6344 (11.79) | 2871 (12.86) | 2356 (11.54) | 1117 (12.21) | |
| History of Cancer | 1656 (3.08) | 675 (3.02) | 657 (2.98) | 324 (3.44) | 0.080 |
| Tobacco Smoker | 2865 (5.32) | 1077 (4.82) | 1177 (5.34) | 611 (6.48) | <0.001 |
| PRA | |||||
| 0 | 33 918 (63.03) | 14 841 (66.49) | 13 151 (59.62) | 5926 (62.84) | <0.001 |
| >0 and ≤80 | 15 711 (29.20) | 6088 (27.27) | 7013 (31.79) | 2610 (27.68) | |
| >80 | 4181 (7.77) | 1393 (6.24) | 1894 (8.59) | 894 (9.48) | |
| Years on Dialysis at Waitlisting | |||||
| 0 | 1043 (1.94) | 525 (2.35) | 360 (1.63) | 158 (1.68) | <0.001 |
| 1 | 20 859 (38.76) | 9361 (41.94) | 8174 (37.06) | 3324 (35.25) | |
| 2 | 14 049 (26.11) | 5699 (25.53) | 5916 (26.82) | 2434 (25.81) | |
| 3+ | 17 859 (33.19) | 6737 (30.18) | 7608 (34.49) | 3514 (37.26) | |
| Access type | |||||
| AVF | 6824 (12.68) | 3185 (14.27) | 2830 (12.83) | 809 (8.58) | <0.001 |
| Catheter | 27 136 (50.43) | 11 578 (51.87) | 10 971 (49.74) | 4587 (48.64) | |
| Graft | 1260 (2.34) | 466 (2.09) | 574 (2.6) | 220 (2.33) | |
| Peritoneal | 5696 (10.59) | 2522 (11.30) | 2251 (10.2) | 923 (9.79) | |
| Other/unknown | 12 893 (23.96) | 4570 (20.47) | 5432 (24.63) | 2891 (30.66) | |
| Listing year | |||||
| 2005 | 5482 (10.19) | 2121 (9.50) | 2095 (9.5) | 1266 (13.43) | <0.001 |
| 2006 | 5968 (11.09) | 2223 (9.96) | 2457 (11.14) | 1288 (13.66) | |
| 2007 | 6006 (11.16) | 2058 (9.22) | 2644 (11.99) | 1304 (13.83) | |
| 2008 | 5960 (11.08) | 2038 (9.13) | 2742 (12.43) | 1180 (12.51) | |
| 2009 | 6121 (11.38) | 1922 (8.61) | 2900 (13.15) | 1299 (13.78) | |
| 2010 | 6166 (11.46) | 1910 (8.56) | 2982 (13.52) | 1274 (13.51) | |
| 2011 | 5727 (10.64) | 2173 (9.73) | 2658 (12.05) | 896 (9.5) | |
| 2012 | 5861 (10.89) | 2910 (13.04) | 2318 (10.51) | 633 (6.71) | |
| 2013 | 6519 (12.11) | 4967 (22.25) | 1262 (5.72) | 290 (3.08) | |
| Insurance at ESRD Start | |||||
| Employer/Private | 9816 (18.24) | 4386 (19.20) | 3807 (17.26) | 1723 (18.27) | <0.001 |
| Medicaid | 15 476 (28.76) | 5627 (25.21) | 6773 (30.71) | 3076 (32.62) | |
| Medicare | 14 035 (26.08) | 5770 (25.85) | 5702 (25.85) | 2563 (27.18) | |
| No insurance | 9430 (17.52) | 4258 (19.08) | 3816 (17.3) | 1356 (14.38) | |
| Other | 5053 (9.39) | 2381 (10.67) | 1960 (8.89) | 712 (7.55) | |
| Percent of households below poverty line | |||||
| <15% | 5173 (9.61) | 2087 (9.35) | 2177 (9.87) | 909 (9.64) | <0.001 |
| 15–30% | 36 744 (68.28) | 15482 (69.36) | 14899 (67.54) | 6363 (67.48) | |
| >30% | 11 893 (22.10) | 4753 (21.29) | 4982 (22.59) | 2158 (22.88) | |
| Adults with HS diploma | |||||
| ≥85% | 25 816 (47.98) | 11 120 (49.82) | 10 221 (46.34) | 4475 (47.45) | <0.001 |
| <85% | 27 994 (52.02) | 11 202 (50.18) | 11 837 (53.66) | 4955 (52.55) | |
| Willing to accept expanded criteria organ | 30 677 (57.01) | 12 540 (56.18) | 12 654 (57.37) | 5483 (58.14) | 0.002 |
| Urban residence (vs. rural)1 | 44 929 (84.00) | 18 347 (82.62) | 16 999 (84.68) | 9583 (85.52) | <0.001 |
| Hospital beds per 1000 HSA residents (mean, SD)2 | 2.18 (0.80) | 2.17 (0.79) | 2.18 (0.79) | 2.21 (0.81) | <0.001 |
| PCPs per 100 000 HSA residents (mean, SD)2 | 73.78 (20.81) | 73.63 (20.31) | 73.68 (21.24) | 74.26 (20.99) | 0.022 |
| Nephrologists per 100 000 HSA residents (mean, SD)2 | 2.46 (1.20) | 2.42 (1.18) | 2.47 (1.20) | 2.51 (1.23) | <0.001 |
| Average LOS (mean, SD) | 5.8 (5.6) | N/A | 5.2 (5.61) | 7 (5.45) | <0.001 |
All values N (%) unless otherwise specified. Percentages may not sum to 100% because of rounding. 1Missing for 319 subjects. 2Missing for 117 subjects.
Abbreviations: hosp/yr, hospitalizations per year; SD, standard deviation; AVF, arteriovenous fistula; BMI, body mass index; CKD, chronic kidney disease; ESRD, end-stage renal disease; HS, high school; HSA, hospital service area; LOS, hospital length of stay; PCPs, primary care physicians; PRA, panel reactive antibody.