Table 2.

Interfacility variation in mineral metabolism treatment strategies presented as median odds ratio (95% confidence interval)

Treatment StrategiesMedian Odds Ratio (95% Confidence Interval) by Cohort Year
All2006–20082009–20112012–2015
Vitamin D alone1.8 (1.6 to 2.0)2.0 (1.8 to 2.5)1.5 (1.3 to 1.9)1.9 (1.6 to 2.8)
No mineral metabolism medication2.0 (1.8 to 2.3)1.7 (1.5 to 2.0)1.8 (1.6 to 2.2)3.2 (2.7 to 4.0)
Cinacalcet-containing 1.9 (1.7 to 2.1)1.7 (1.5 to 2.1)2.0 (1.8 to 2.5)2.6 (2.2 to 3.2)
Phosphate binder alone1.9 (1.8 to 2.1)1.6 (1.5 to 1.8)1.9 (1.7 to 2.1)3.5 (3.0 to 4.2)
Number of groups (facilities)359253257265
Number of patients15,591539952254967
  • The reference strategy is vitamin D sterol and phosphate binder. Model is adjusted for age (linear and quadratic term), comorbidity, sex, race (Black, White, and other), and insurance status. The median odds ratio for a specified strategy describes the effect of the facility on receiving that strategy, rather than the reference strategy, for two otherwise similar patients. A median odds ratio near one implies facility variation plays a minor role in the probability of receiving the specified strategy; larger values indicate greater discrepancies across facilities, after controlling for patient characteristics. A median odds ratio of 1.8 implies a median increase of 80% in the odds of using that strategy (relative to the reference strategy) when a patient is switched from a facility with lower odds to one with greater odds, holding all other predictors constant.