National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013

Measures

Adult hemodialysis patients whose primary mode of vascular access is an arteriovenous fistula (AVF)
Ratio of observed deaths to expected deaths among Medicare hemodialysis patients
Dialysis patients under age 70 who were registered on a waiting list for transplantation within a year of initiation
Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure
End stage renal disease (ESRD) patients who visited a nephrologist before renal replacement therapy
 

Measure Title

Adult hemodialysis patients whose primary mode of vascular access is an arteriovenous fistula (AVF)

Measure Source

Centers for Medicare & Medicaid Services (CMS), End Stage Renal Disease (ESRD), Standard Information Management System (SIMS)

Table Description

Geographic Representation

National, State

Years Available

State: 2008-2011

National: 2008-2011

Population Subgroups

Age, sex, race/ethnicity

Data Sources

National & State

CMS Fistula First Incident AVF Dataset

Denominator

All patients in 18 ESRD networks who began outpatient dialysis in the designated year

Numerator

Subset of the denominator who initiated dialysis with an AVF

Comments

Data for 2009 and 2010 were drawn from the SIMS Central Repository on May 17, 2011.

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Measure Title

Ratio of observed deaths to expected deaths among dialysis patients

Measure Source

University of Michigan Kidney Epidemiology and Cost Center (UM-KECC), Dialysis Facility Report (DFR)

Table Description

Geographic Representation

State

Years Available

2008-2011

Data Sources

UM-KECC, DFR

State Denominator

Dialysis patients

State Numerator

Standardized mortality among the population in the denominator

Comments

This measure is equivalent to the Medicare Compare measure pertaining to Dialysis Facility, "patient survival rate."

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Measure Title

Dialysis patients under age 70 who were registered on a waiting list for transplantation within a year of initiation

Measure Source

Healthy People 2020

Table Description

Geographic Representation

National, State

Years Available

State: 2000-2009

National: 2000-2009

Population Subgroups

Age, sex, race/ethnicity

Data Sources

National and State

National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)

Denominator

All incident end stage renal disease (ESRD) patients with Medicare who are under the age of 70 and known to reside in the 50 States or DC. Patients who received a transplant at any time from a live donor were excluded from the measure.

Numerator

Subset of the denominator registered on the kidney transplant waiting list on December 31 of the measure year or received a deceased-donor kidney within 1 year of their ESRD initiation date

Comments

The measure was calculated as the percentage (by Kaplan-Meier methodology) who were either wait-listed or received a deceased-donor kidney within 1 year of their ESRD initiation date. This measure is referred to as measure CKD-12 in Healthy People 2020 documentation.

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Measure Title

Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure

Measure Source

Healthy People 2020

Table Description

Geographic Representation

National, State

Years Available

State: 2000-2007

National: 2000-2007

Population Subgroups

Age, sex, race/ethnicity

Data Sources

National and State

National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)

Denominator

All Medicare dialysis patients who initiated therapy in the given year Patients with prior kidney transplants and those over the age of 69 were excluded.

Numerator

Subset of the denominator that received a transplant within 3 years of renal failure

Comments

This measure is referred to as measure CKD-13.1 in Healthy People 2020 documentation.

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Measure Title

End stage renal disease (ESRD) patients who visited a nephrologist before renal replacement therapy

Measure Source

National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), U.S. Renal Data System (USRDS)

Table Description

Geographic Representation

National, State

Years Available

State: 2010

National: 2005-2010

Population Subgroups

Age, sex, race/ethnicity

Data Sources

National and State

National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)

Denominator

All incident ESRD patients age 18 and over

Numerator

Subset of the denominator who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy

Comments

This measure is referred to as measure CKD-10 in Healthy People 2020 documentation.

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