Pilot 5
Disparities in access to higher quality health care: access to and choice of an initial renal dialysis provider
(M. Turenne PI)
(1-year pilot)
Factors that limit the choice of a health care provider may lead to disparities in access to higher quality care. This study focuses on determinants of the initial renal dialysis provider for individuals with end-stage renal disease (ESRD). The goal of this study is to determine whether there are patterns in access to and choice of an initial dialysis provider that could lead to disparities in patient access to higher quality dialysis services. This will be accomplished by examining the relationship of race, ethnicity, socioeconomic factors, and geographic location with the following factors:
• The availability and extent of choice of dialysis providers
• The accessibility of higher quality dialysis providers
• The use of information about quality of care in selecting a dialysis provider
There will be a particular emphasis on the implications for African Americans, who have been reported to have worse pre-ESRD care and poorer indicators of the quality of dialysis care.