Effect of End-Stage Renal Disease Prospective Payment System on Utilization of Peritoneal Dialysis in Patients with Kidney Allograft Failure

• DOI: 10.1159/000539062
• Publication Date: 2024-05-16T21:01:48Z
• Authors: Ali I. Gardezi; Zhongyu Yuan; Fahad Aziz; Sandesh Parajuli; Didier Mandelbrot; Micah R. Chan; Brad C. Astor
• Keywords: Male; Adult; Prospective Payment System; Interrupted Time Series Analysis; Middle Aged; Allografts; Kidney Transplantation; United States; 03 medical and health sciences; 0302 clinical medicine; Humans; Kidney Failure, Chronic; Female; Peritoneal Dialysis; Aged

Introduction: The Center for Medicare and Medicaid Services introduced an End-Stage Renal Disease Prospective Payment System (PPS) in 2011 to increase the utilization of home dialysis modalities, including peritoneal (PD). Several studies have shown a significant PD after PPS implementation. However, its impact on patients with kidney allograft failure remains unknown. Methods: We conducted interrupted time series analysis using data from US Data (USRDS) that include all adult transplant recipients who started between 2005 2019. compared pre-PPS period (2005–2010) fully implemented post-PPS (2014–2019) early (within 90 days) late (91–365 experience. Results: A total 27,507 during study period. There was no difference either immediate change (0.3% increase; 95% CI: −1.95%, 2.54%; p = 0.79) or rate over (0.28% per year; −0.16%, 0.72%; 0.18). Subgroup analyses revealed trend toward higher for-profit large-volume units. units low experience Similar findings were seen Conclusion: did not significantly overall initiating failure.