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<h1 class="page__title title" id="page-title">National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013</h1>
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<div class="field field-name-field-subtitle field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Effectiveness of Care: Chronic Kidney Disease</div></div></div><div class="field field-name-ahrq-generic-body field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p><a id="top" name="top"> </a></p>
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<h3>Measures</h3>
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<p><a href="#kidney1">Adult hemodialysis patients whose primary mode of vascular access is an arteriovenous fistula (AVF)</a><br />
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<a href="#kidney2">Ratio of observed deaths to expected deaths among Medicare hemodialysis patients</a><br />
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<a href="#kidney3">Dialysis patients under age 70 who were registered on a waiting list for transplantation within a year of initiation</a><br />
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<a href="#kidney4">Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure</a><br />
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<a href="#kidney5">End stage renal disease (ESRD) patients who visited a nephrologist before renal replacement therapy</a><br />
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</p>
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<hr />
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<p><a id="kidney1" name="kidney1"> </a></p>
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<h3>Measure Title</h3>
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<p>Adult hemodialysis patients whose primary mode of vascular access is an arteriovenous fistula (AVF)</p>
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<h3>Measure Source</h3>
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<p>Centers for Medicare & Medicaid Services (CMS), End Stage Renal Disease (ESRD), Standard Information Management System (SIMS)</p>
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<h3>Table Description</h3>
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<h4>Geographic Representation</h4>
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<p>National, State</p>
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<h4>Years Available</h4>
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<p>State: 2008-2011</p>
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<p>National: 2008-2011</p>
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<h4>Population Subgroups</h4>
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<p>Age, sex, race/ethnicity</p>
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<h3>Data Sources</h3>
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<h4>National & State</h4>
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<p>CMS Fistula First Incident AVF Dataset</p>
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<h3>Denominator</h3>
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<p>All patients in 18 ESRD networks who began outpatient dialysis in the designated year</p>
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<h3>Numerator</h3>
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<p>Subset of the denominator who initiated dialysis with an AVF</p>
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<h3>Comments</h3>
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<p>Data for 2009 and 2010 were drawn from the SIMS Central Repository on May 17, 2011.</p>
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<p class="size2"><a href="#top">Top of Page</a></p>
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<hr />
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<p><a id="kidney2" name="kidney2"> </a></p>
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<h3>Measure Title</h3>
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<p>Ratio of observed deaths to expected deaths among dialysis patients</p>
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<h3>Measure Source</h3>
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<p>University of Michigan Kidney Epidemiology and Cost Center (UM-KECC), Dialysis Facility Report (DFR)</p>
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<h3>Table Description</h3>
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<h4>Geographic Representation</h4>
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<p>State</p>
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<h4>Years Available</h4>
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<p>2008-2011</p>
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<h3>Data Sources</h3>
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<p>UM-KECC, DFR</p>
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<h3>State Denominator</h3>
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<p>Dialysis patients</p>
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<h3>State Numerator</h3>
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<p>Standardized mortality among the population in the denominator</p>
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<h3>Comments</h3>
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<p>This measure is equivalent to the Medicare Compare measure pertaining to Dialysis Facility, "patient survival rate."</p>
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<p class="size2"><a href="#top">Top of Page</a></p>
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<hr />
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<p><a id="kidney3" name="kidney3"> </a></p>
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<h3>Measure Title</h3>
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<p>Dialysis patients under age 70 who were registered on a waiting list for transplantation within a year of initiation</p>
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<h3>Measure Source</h3>
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<p>Healthy People 2020</p>
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<h3>Table Description</h3>
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<h4>Geographic Representation</h4>
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<p>National, State</p>
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<h4>Years Available</h4>
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<p>State: 2000-2009</p>
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<p>National: 2000-2009</p>
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<h4>Population Subgroups</h4>
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<p>Age, sex, race/ethnicity</p>
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<h3>Data Sources</h3>
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<h4>National and State</h4>
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<p>National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)</p>
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<h3>Denominator</h3>
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<p>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.</p>
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<h3>Numerator</h3>
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<p>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</p>
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<h3>Comments</h3>
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<p>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.</p>
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<p class="size2"><a href="#top">Top of Page</a></p>
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<hr />
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<p><a id="kidney4" name="kidney4"> </a></p>
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<h3>Measure Title</h3>
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<p>Patients with treated chronic kidney failure who received a transplant within 3 years of date of renal failure</p>
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<h3>Measure Source</h3>
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<p>Healthy People 2020</p>
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<h3>Table Description</h3>
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<h4>Geographic Representation</h4>
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<p>National, State</p>
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<h4>Years Available</h4>
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<p>State: 2000-2007</p>
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<p>National: 2000-2007</p>
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<h4>Population Subgroups</h4>
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<p>Age, sex, race/ethnicity</p>
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<h3>Data Sources</h3>
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<h4>National and State</h4>
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<p>National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)</p>
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<h3>Denominator</h3>
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<p>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.</p>
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<h3>Numerator</h3>
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<p>Subset of the denominator that received a transplant within 3 years of renal failure</p>
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<h3>Comments</h3>
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<p>This measure is referred to as measure CKD-13.1 in Healthy People 2020 documentation.</p>
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<p class="size2"><a href="#top">Top of Page</a></p>
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<hr />
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<p><a id="kidney5" name="kidney5"> </a></p>
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<h3>Measure Title</h3>
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<p>End stage renal disease (ESRD) patients who visited a nephrologist before renal replacement therapy</p>
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<h3>Measure Source</h3>
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<p>National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), U.S. Renal Data System (USRDS)</p>
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<h3>Table Description</h3>
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<h4>Geographic Representation</h4>
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<p>National, State</p>
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<h4>Years Available</h4>
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<p>State: 2010</p>
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<p>National: 2005-2010</p>
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<h4>Population Subgroups</h4>
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<p>Age, sex, race/ethnicity</p>
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<h3>Data Sources</h3>
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<h4>National and State</h4>
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<p>National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS)</p>
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<h3>Denominator</h3>
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<p>All incident ESRD patients age 18 and over</p>
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<h3>Numerator</h3>
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<p>Subset of the denominator who saw a nephrologist at least 12 months prior to initiation of renal replacement therapy</p>
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<h3>Comments</h3>
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<p>This measure is referred to as measure CKD-10 in Healthy People 2020 documentation.</p>
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<p class="size2"><a href="#top">Top of Page</a></p>
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<p class="size2"><a href="/research/findings/nhqrdr/nhqrdr13/measurespec/index.html">Return to Contents</a><br />
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<a href="/research/findings/nhqrdr/nhqrdr13/measurespec/diabetes.html">Proceed to Next Section</a></p>
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</div></div></div><div class="field field-name-field-last-reviewed field-type-datestamp field-label-hidden">
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Page last reviewed <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2014-07-01T00:00:00-04:00">July 2014</span> <br />Page originally created July 2014 </div>
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Internet Citation: National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013. Content last reviewed July 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqrdr13/measurespec/kidney.html<div class="citation-flag"></div>
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Agency for Healthcare Research and Quality <img alt="" src="/images/bottom_dot.gif"> 5600 Fishers Lane Rockville, MD 20857 <img alt="" src="/images/bottom_dot.gif">
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Telephone: (301) 427-1364
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