Table 2.
Facility-level variation in care among patients with diabetes and stage 3 CKD (eGFR 30–59 ml/min per 1.73 m2)
| Measures of CKD Care | Proportion of Patients Receiving Core Measures in %, Median (Interquartile Range) | MRR (95% CI), Unadjusted | MRR (95% CI), Adjusted for Patient-Level Variablesa | MRR (95% CI), Fully Adjustedb |
|---|---|---|---|---|
| UACR/UPR measurement in the 12 mo after the index primary care visit | 37 (22–47) | 1400 (543 to 3230) | 5.2 (4.0 to 6.4) | 5.2 (4.1 to 6.4) |
| Hemoglobin measurement in the 12 mo after the index primary care visit | 74 (72–79) | 132 (70 to 232) | 2.3 (2.0 to 2.5) | 2.4 (2.1 to 2.6) |
| Prescription of ACEIs/ARBs either 12 mo before or after the index primary care visit | 66 (62–69) | 14 (10 to 19) | 1.3 (1.2 to 1.3) | 1.3 (1.2 to 1.3) |
| Prescription of statins either 12 mo before or after the index primary care visit | 85 (74–87) | 2.8 (2.5 to 3.2) | 1.23 (1.2 to 1.3) | 1.2 (1.2 to 1.3) |
| Patients with at least one BP reading <140/90 mm Hg in the 6 mo after the index primary care visit | 47 (42–53) | 36 (23 to 55) | 1.4 (1.3 to 1.5) | 1.4 (1.3 to 1.4) |
| Patients meeting all measures | 13 (7–16) | 17 (12 to 24) | 4.1 (3.3 to 5.0) | 4.1 (3.3 to 5.0) |
MRR, median rate ratio; 95% CI, 95% confidence interval; UACR, urine albumin-to-creatinine ratio; UPR, urine protein-to-creatinine ratio; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker.
MRR adjusted for patient’s age, sex, race (white versus other), history of hypertension, history of cardiovascular disease, diagnostic cost group relative risk score (continuous) of patients, insulin use, use of Medicare, and eGFR (patient-level variables).
MRR adjusted for variables above, plus teaching versus nonteaching facility, receipt of care from a physician versus nonphysician primary care provider, and the number of primary care visits 1 year before the index primary care visit (facility- and provider-level variables).