. 2019 Sep 10;322(10):957–973. doi: 10.1001/jama.2019.12803

Table 3. Crude and Adjusted Hierarchical Cox Proportional Hazard Ratios Between Dialysis Facility Ownership and Placement on the Deceased Donor Kidney Transplantation Waiting List, Receipt of a Living Donor Kidney Transplant, or Deceased Donor Kidney Transplant by Patient-Level and Facility-Level Characteristics, 2000-2016^a.

	Cumulative Incidence Difference, % (95% CI)^b			Hazard Ratio (95% CI)
	At 3 y	At 5 y	At 10 y	Crude Model (n = 1 478 564)	Adjusted for Demographics (n = 1 478 564)^c	+ Clinical Characteristics (n = 1 478 506)^d	+ Socioeconomic and Geographic Characteristics (n = 1 478 506)^e
Placement on Deceased Donor Kidney Transplantation Waiting List (n = 121 680)
Nonprofit dialysis facilities
Small chains	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Independent	17.1 (16.8 to 17.5)	18.4 (18.1 to 18.8)	19.1 (18.7 to 19.5)	2.74 (2.68 to 2.80)	2.46 (2.41 to 2.51)	2.48 (2.42 to 2.53)	2.36 (2.31 to 2.42)
For-profit dialysis facilities
Large chain 1	−4.9 (−5.1 to −4.7)	−5.0 (−5.2 to −4.8)	−4.9 (−5.1 to −4.7)	0.58 (0.57 to 0.59)	0.58 (0.57 to 0.59)	0.57 (0.56 to 0.58)	0.57 (0.56 to 0.58)
Large chain 2	−5.7 (−5.9 to −5.5)	−5.9 (−6.1 to −5.7)	−5.9 (−6.1 to −5.7)	0.52 (0.50 to 0.53)	0.53 (0.52 to 0.54)	0.55 (0.54 to 0.56)	0.54 (0.53 to 0.55)
Small chains	−5.2 (−5.4 to −5.0)	−5.4 (−5.7 to −5.2)	−5.4 (−5.6 to −5.2)	0.55 (0.54 to 0.56)	0.56 (0.55 to 0.57)	0.56 (0.55 to 0.57)	0.56 (0.54 to 0.57)
Independent	−5.0 (−5.2 to −4.8)	−5.1 (−5.3 to −4.8)	−5.0 (−5.3 to −4.8)	0.59 (0.57 to 0.61)	0.61 (0.60 to 0.63)	0.59 (0.57 to 0.61)	0.60 (0.58 to 0.61)
All facilities
Nonprofit	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
For-profit	−12.5 (−12.7 to −12.3)	−13.2 (−13.4 to −13.0)	−13.4 (−13.6 to −13.2)	0.33 (0.32 to 0.33)	0.35 (0.34 to 0.35)	0.34 (0.34 to 0.35)	0.36 (0.35 to 0.36)
Receipt of a Living Donor Kidney Transplant (n = 23 762)
Nonprofit dialysis facilities
Small chains	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Independent	2.3 (2.1 to 2.5)	2.7 (2.5 to 2.9)	3.0 (2.8 to 3.2)	1.90 (1.81 to 2.00)	1.59 (1.51 to 1.67)	1.52 (1.44 to 1.59)	1.33 (1.26 to 1.40)
For-profit dialysis facilities
Large chain 1	−1.0 (−1.1 to −1.0)	−1.1 (−1.2 to −1.0)	−1.2 (−1.3 to −1.1)	0.57 (0.54 to 0.60)	0.61 (0.58 to 0.63)	0.61 (0.58 to 0.63)	0.61 (0.58 to 0.63)
Large chain 2	−1.1 (−1.2 to −1.0)	−1.2 (−1.3 to −1.1)	−1.3 (−1.4 to −1.2)	0.55 (0.53 to 0.58)	0.59 (0.57 to 0.62)	0.62 (0.60 to 0.65)	0.60 (0.57 to 0.63)
Small chains	−1.2 (−1.3 to −1.1)	−1.4 (−1.5 to −1.2)	−1.4 (−1.5 to −1.3)	0.49 (0.47 to 0.52)	0.55 (0.52 to 0.58)	0.56 (0.53 to 0.59)	0.61 (0.58 to 0.64)
Independent	−1.0 (−1.1 to −0.9)	−1.2 (−1.3 to −1.0)	−1.2 (−1.3 to −1.1)	0.59 (0.55 to 0.62)	0.68 (0.64 to 0.72)	0.69 (0.64 to 0.73)	0.70 (0.65 to 0.74)
All facilities
Nonprofit	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
For-profit	−2.1 (−2.1 to −2.0)	−2.3 (−2.4 to −2.3)	−2.5 (−2.6 to −2.4)	0.40 (0.39 to 0.41)	0.47 (0.45 to 0.48)	0.49 (0.47 to 0.50)	0.52 (0.51 to 0.54)
Receipt of a Deceased Donor Kidney Transplant (n = 49 290)
Nonprofit dialysis facilities
Small chains	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
Independent	2.5 (2.4 to 2.7)	5.3 (5.1 to 5.6)	9.1 (8.8 to 9.4)	2.07 (2.00 to 2.14)	1.82 (1.76 to 1.88)	1.82 (1.76 to 1.88)	1.71 (1.66 to 1.77)
For-profit dialysis facilities
Large chain 1	−1.2 (−1.3 to −1.1)	−2.0 (−2.1 to −1.8)	−2.5 (−2.6 to −2.3)	0.60 (0.58 to 0.62)	0.62 (0.60 to 0.64)	0.60 (0.58 to 0.62)	0.60 (0.58 to 0.62)
Large chain 2	−1.2 (−1.3 to −1.1)	−2.1 (−2.3 to −2.0)	−2.9 (−3.1 to −2.8)	0.56 (0.54 to 0.58)	0.58 (0.57 to 0.60)	0.61 (0.59 to 0.63)	0.59 (0.57 to 0.61)
Small chains	−1.2 (−1.3 to −1.1)	−2.1 (−2.3 to −2.0)	−2.8 (−3.0 to −2.7)	0.56 (0.54 to 0.58)	0.59 (0.57 to 0.61)	0.58 (0.56 to 0.61)	0.60 (0.58 to 0.62)
Independent	−1.4 (−1.5 to −1.2)	−2.4 (−2.5 to −2.2)	−2.9 (−3.1 to −2.7)	0.54 (0.52 to 0.57)	0.59 (0.57 to 0.62)	0.58 (0.56 to 0.61)	0.59 (0.56 to 0.62)
All facilities
Nonprofit	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]	1 [Reference]
For-profit	−2.3 (−2.4 to −2.2)	−4.3 (−4.4 to −4.2)	−6.6 (−6.7 to −6.4)	0.39 (0.38 to 0.40)	0.43 (0.42 to 0.44)	0.43 (0.42 to 0.44)	0.44 (0.44 to 0.45)

^{^a}

Patients were assigned to the last dialysis facility from which they were receiving treatment when the outcome event of interest occurred.

^{^b}

Calculated using the Aalen-Johansen estimator and was adjusted for competing risk of death.

^{^c}

Age, sex, and race reported at dialysis start.

^{^d}

Body mass index greater than 35, attributed cause of end-stage kidney disease, congestive heart failure, atherosclerotic heart disease, other cardiac disease, cerebrovascular disease, peripheral vascular disease, hypertension, diabetes, chronic obstructive pulmonary disease, tobacco use, cancer reported at dialysis start, and type of dialysis. Multiple imputation was used because of missing data for type of dialysis (7805 patients; 0.5%).

^{^e}

End-Stage Renal Disease Network geographic area of assigned facility; insurance coverage reported at dialysis start; facility located in metropolitan, rural-urban classification; distance from assigned dialysis facility to the nearest transplant center; and not informed of transplant options due to medical reasons. Multiple imputation was used because of missing data for insurance coverage (115 322 patients; 7.8%); distance from assigned dialysis facility to nearest transplant center (319 117 patients; 21.6%); and metropolitan, rural-urban classification (13 322 patients; 0.9%).