Table 3.

Facility-level variation among patients with diabetes and stage 4 CKD (eGFR 15–29 ml/min per 1.73 m2)

Measures of CKD CareProportion of Patients Receiving Recommended Care Measures in %, Median (Interquartile Range)MRR (95% CI), UnadjustedMRR (95% CI), Adjusted for Patient-Level VariablesaMRR (95% CI), Fully Adjustedb
UACR/UPR measurement in the 12 mo after the index primary care visit29 (17–41)9.7 (7.2 to 13)3.2 (2.7 to 3.7)3.2 (2.7 to 3.7)
Hemoglobin measurement in the 12 mo after the index primary care visit73 (69–77)5.4 (4.3 to 6.5)1.9 (1.7 to 2.1)1.9 (1.7 to 2.1)
Prescription of ACEIs/ARBs either 12 mo before or after the index primary care visit61 (55–66)3.2 (2.7 to 3.6)1.3 (1.2 to 1.4)1.3 (1.2 to 1.4)
Prescription of statins either 12 mo before or after the index primary care visit85 (82–87)1.6 (1.5 to 1.7)1.2 (1.1 to 1.2)1.2 (1.1 to 1.2)
Patients with at least one BP reading <140/90 mm Hg in the 6 mo after the index primary care visit49 (41–56)3.8 (3.2 to 4.5)1.4 (1.3 to 1.5)1.4 (1.3 to 1.5)
Patients seen by a nephrologist in the 12 mo after the index primary care visit38 (20–46)8.0 (6.1 to 10.2)4.6 (3.6 to 5.7)4.6 (3.6 to 5.8)
Patients meeting all measures5 (1–13)2.6 (2.3 to 2.9)3.7 (2.9 to 4.4)3.6 (2.9 to 4.3)
  • MRR, median rate ratio; 95% CI, 95% confidence interval; UACR, urine albumin-to-creatinine ratio; UPR, urine protein-to-creatinine ratio; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker.

  • a MRR adjusted for patient’s age, sex, race (white versus other), history of hypertension, history of cardiovascular disease, diagnostic cost group relative risk score (continuous) of patients, insulin use, use of Medicare, and eGFR (patient-level variables).

  • b MRR adjusted for variables above, plus teaching versus nonteaching facility, receipt of care from a physician versus nonphysician primary care provider, and the number of primary care visits 1 year before the index primary care visit (facility- and provider-level variables).