Table 3.

Associations of three facility-level aggregate exposures with patient cinacalcet prescription

Model 1Model 2Model 3Model 4
Facility-Level ExposureAPD95% CIAPD95% CIAPD95% CIAPD95% CI
Facility % black patients
 <7 (ref)0%(ref)0%(ref)0%(ref)0%(ref)
 7–313.9%(−0.6% to 8.3%)3.6%(−1.0% to 8.2%)4.2%(0.5% to 7.9%)2.4%(−1.2% to 5.9%)
 31–577.4%(−0.05% to 14.9%)7.4%(−0.02% to 14.8%)5.4%(−1.2% to 12.0%)0.9%(−5.4% to 7.3%)
 57+12.4%(3.9% to 20.8%)12.6%(4.2% to 20.8%)7.8%(0.8% to 14.8%)−0.04%(−7.1% to 7.0%)
P value for linear trend0.0030.0020.030.9
Facility % patients aged 65 yr
 <38 (ref)0%(ref)0%(ref)0%(ref)0%(ref)
 38–495.0%(−0.02% to 10.0%)4.9%(−0.1% to 9.8%)2.7%(−1.8% to 7.2%)2.2%(−2.3% to 6.8%)
 49–646.4%(0.3% to 12.4%)6.1%(−0.05% to 12.3%)3.0%(−2.5% to 8.7%)2.0%(−3.7% to 7.5%)
 64+14.7%(5.9% to 23.6%)14.4%(5.4% to 23.3%)7.3%(−0.1% to 14.7%)5.6%(−1.8% to 13.1%)
P value for linear trend0.0010.0020.060.2
Facility % patient on dialysis 3+ yr
 <41 (ref)0%(ref)0%(ref)0%(ref)0%(ref)
 41–484.2%(−0.9% to 9.4%)3.3%(−2.0% to 8.5%)5.7%(0.3% to 11.0%)3.0%(−2.0% to 8.0%)
 48–567.7%(0.9% to 14.4%)6.9%(0.1% to 13.7%)6.0%(−1.3% to 13.3%)2.4%(−4.3% to 9.1%)
 56+15.4%(6.4% to 24.3%)16.2%(6.9% to 25.5%)11.9%(2.4% to 21.4%)5.1%(−3.9% to 14.1%)
P value for linear trend0.0010.0010.020.3
  • Shown are the associations between the prevalence of patient cinacalcet prescription and each main facility-level exposure (using separate models) as an adjusted prevalence difference (APD) with 95% confidence interval (95% CI). The first quartile of each main facility-level exposure is treated as the reference group, and the estimated associations are cumulatively adjusted for potential confounders using linear mixed-effect models. Model 1 included each main exposure with no covariates. Model 2 adjusted the estimated effect of each exposure for facility chain affiliation, small facility volume (±25 patients), and rural versus urban location. Model 3 added adjustment for the patient’s age, race (black versus other), vintage, sex, body mass index, and body surface area, excluding the patient-level covariate corresponding to the facility-level exposure of interest; e.g., excluding black race when estimating the association between facility percentage black patients and the outcome. Model 4 added the patient-level covariate corresponding to the facility-level exposure of interest, e.g., including black race when estimating the association between facility percentage black patients and the outcome.