Early winners and losers in dialysis center pay-for-performance

Table 4 Multivariable regression for change in clinical performance 2007–2010 by facility and neighborhood co-variates

Co-Variates	Change in Hgb <10 g/dL [95% CI]^b	Change in Hgb > 12 g/dL [95% CI]^b	Change in URR < 65 [95% CI]^c
Co-Variates	Coefficients	Coefficients	Coefficients
Facility Level Characteristics
Chain Type
Other chain	Referent	Referent	Referent
Chain 1	−0.38^a [−0.68, −0.67]	−12.69^a [−14.41, −10.98]	0.91^a [0.42, 1.41]
Chain 2	−0.41^a [−0.72, −0.10]	−0.46 [−2.19, 1.26]	0.14 [−0.35, 0.64]
Independent	−0.08 [−0.41, 0.26]	3.72^a [1.84, 5.59]	−0.06 [−0.60, 0.49]
Total # Stations (per station)
Low (0–13)	Referent	Referent	Referent
Medium (14–20)	−0.11 [−0.39, 0.17]	0.12 [−0.47, 1.70]	−0.33 [−0.79, 0.14]
High (21–80)	0.11 [−0.20, 0.42]	0.77 [−0.96, 2.49]	−0.37 [−0.87, 0.13]
Length of Operation (per year)	0.02^a [0.00, 0.03]	0.03 [−0.04, 0.11]	−0.003 [−0.03, 0.02]
Neighborhood Level Characteristics
Percent African-American
Quartile 1 ≤ 8.6%	Referent	Referent	Referent
Quartile 2 8.6%–15.7%	0.07 [−0.25, 0.39]	−1.22 [−3.00, 0.57]	−0.63^a [−1.15, −0.11]
Quartile 3 15.7% −25%	0.19 [−0.12, 0.55]	-2.42^a [−4.29, −0.54]	−0.53^a [−1.07, 0.01]
Quartile 4 > 24.7%	0.04 [−0.29, 0.45]	−3.43^a [−5.52, −1.34]	−0.85^a [−1.05, −0.27]
Percent Below Federal Poverty Level
Quartile 1 ≤ 1.7%	Referent	Referent	Referent
Quartile 2 1.7% - 7.2%	0.06 [−0.25, 0.38]	−0.33 [−2.08, 1.43]	0.09 [−0.42, 0.60]
Quartile 3 7.2% - 24.9%	0.04 [−0.28, 0.37]	−0.53 [−2.35, 1.29]	0.19 [−0.34, 0.71]
Quartile 4 > 24.7%	0.13 [−0.21, 0.47]	0.80 [−1.10, 2.71]	0.30 [−0.25, 0.85]

^a p < 0.05. ^bHemoglobin (Hgb) goals: 10 ≤ Hgb ≤ 12, so decreasing proportion less than 10 or greater than 12 (negative sign) is a positive clinical change. ^cInadequate dialysis is Urea Reduction Rate (URR) <65 so decreasing proportion of URR < 65 (negative sign) is a positive clinical change. Confidence intervals are at the 95% significance level. Multivariable model includes profit status, total number of stations (by tertile), length of operation, percent African American by facility neighborhood (by quartile), percent below Federal Poverty Level by facility neighborhood (by quartile)

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