Treatment Strategies | Median Odds Ratio (95% Confidence Interval) by Cohort Year | |||
---|---|---|---|---|

All | 2006–2008 | 2009–2011 | 2012–2015 | |

Vitamin D alone | 1.8 (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 medication | 2.0 (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 alone | 1.9 (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) | 359 | 253 | 257 | 265 |

Number of patients | 15,591 | 5399 | 5225 | 4967 |

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.