Table 4.

Odds ratios of primary outcome (withdrawal of dialysis and death in either a non-hospital or hospice setting), and of component outcomes, according to minority status in patients on dialysis dying between 2000 and 2014, analyzed separately in subgroups defined by insurance provider

VariableModel 1Model 2Model 3Model 4
Medicare A/BHMOMedicare A/BHMOMedicare A/BHMOMedicare A/B
Primary outcome (Medicare A/B, 17.9% of 818,953/HMO, 22.1% of 124,246)
 Non-Hispanic white1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)
 Minority0.41 (0.41 to 0.42)0.48 (0.46 to 0.49)0.48 (0.47 to 0.48)0.5 (0.49 to 0.52)0.56 (0.55 to 0.56)0.60 (0.58 to 0.62)0.55 (0.55 to 0.56)
 Non-Hispanic black0.37 (0.37 to 0.38)0.42 (0.41 to 0.44)0.44 (0.43 to 0.45)0.45 (0.43 to 0.47)0.50 (0.49 to 0.51)0.51 (0.49 to 0.54)0.50 (0.49 to 0.51)
 Non-Hispanic Native American0.58 (0.54 to 0.61)0.60 (0.45 to 0.81)0.71 (0.67 to 0.76)0.71 (0.52 to 0.95)a0.70 (0.66 to 0.74)0.70 (0.51 to 0.95)a0.69 (0.65 to 0.74)
 Non-Hispanic Asian0.41 (0.40 to 0.43)0.49 (0.46 to 0.53)0.40 (0.39 to 0.42)0.51 (0.47 to 0.55)0.47 (0.45 to 0.50)0.54 (0.50 to 0.58)0.47 (0.45 to 0.5)
 Hispanic0.51 (0.50 to 0.52)0.55 (0.53 to 0.57)0.57 (0.56 to 0.58)0.58 (0.55 to 0.60)0.72 (0.7 to 0.74)0.78 (0.74 to 0.82)0.72 (0.70 to 0.74)
Dialysis discontinuation (Medicare A/B, 25.5% of 818,953/HMO, 28.8% of 124,246)
 Non-Hispanic white1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)
 Minority0.44 (0.43 to 0.44)0.49 (0.48 to 0.50)0.50 (0.49 to 0.50)0.52 (0.50 to 0.53)0.58 (0.57 to 0.59)0.63 (0.61 to 0.64)0.58 (0.57 to 0.59)
 Non-Hispanic black0.40 (0.39 to 0.40)0.44 (0.42 to 0.45)0.46 (0.45 to 0.47)0.46 (0.45 to 0.48)0.53 (0.52 to 0.53)0.54 (0.52 to 0.56)0.52 (0.52 to 0.53)
 Non-Hispanic Native American0.66 (0.63 to 0.69)0.67 (0.51 to 0.87)b0.80 (0.76 to 0.84)0.77 (0.59 to 1.01)c0.77 (0.73 to 0.81)0.77 (0.59 to 1.00)c0.77 (0.73 to 0.81)
 Non-Hispanic Asian0.47 (0.45 to 0.49)0.59 (0.55 to 0.62)0.47 (0.46 to 0.49)0.60 (0.56 to 0.64)0.55 (0.53 to 0.57)0.64 (0.60 to 0.68)0.55 (0.53 to 0.57)
 Hispanic0.51 (0.50 to 0.51)0.53 (0.51 to 0.56)0.57 (0.56 to 0.58)0.57 (0.55 to 0.59)0.72 (0.70 to 0.73)0.78 (0.74 to 0.81)0.72 (0.7 to 0.73)
Hospice (Medicare A/B, 14.5% of 818,953/HMO, 20.1% of 124,246)
 Non-Hispanic white1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)
 Minority0.52 (0.52 to 0.53)0.59 (0.57 to 0.61)0.57 (0.56 to 0.58)0.59 (0.57 to 0.60)0.63 (0.62 to 0.64)0.68 (0.66 to 0.70)0.63 (0.62 to 0.64)
 Non-Hispanic black0.48 (0.47 to 0.49)0.54 (0.52 to 0.56)0.54 (0.53 to 0.55)0.54 (0.52 to 0.56)0.59 (0.58 to 0.60)0.59 (0.57 to 0.62)0.59 (0.58 to 0.6)
 Non-Hispanic Native American0.58 (0.54 to 0.62)0.86 (0.65 to 1.14)c0.67 (0.62 to 0.71)0.98 (0.73 to 1.31)c0.69 (0.64 to 0.74)0.98 (0.73 to 1.33)c0.69 (0.64 to 0.74)
 Non-Hispanic Asian0.55 (0.52 to 0.57)0.55 (0.51 to 0.60)0.50 (0.47 to 0.52)0.57 (0.53 to 0.62)0.54 (0.51 to 0.56)0.58 (0.54 to 0.63)0.54 (0.51 to 0.56)
 Hispanic0.62 (0.61 to 0.64)0.67 (0.64 to 0.70)0.66 (0.64 to 0.67)0.66 (0.63 to 0.68)0.78 (0.76 to 0.80)0.88 (0.84 to 0.92)0.78 (0.76 to 0.8)
Nonhospital death (Medicare A/B, 41.3% of 818,953/HMO, 45.9% of 124,246)
 Non-Hispanic white1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)1 (Reference)
 Minority0.60 (0.59 to 0.61)0.64 (0.63 to 0.66)0.63 (0.63 to 0.64)0.65 (0.64 to 0.67)0.70 (0.69 to 0.70)0.71 (0.69 to 0.73)0.68 (0.67 to 0.69)
 Non-Hispanic black0.58 (0.58 to 0.59)0.61 (0.59 to 0.63)0.62 (0.62 to 0.63)0.63 (0.61 to 0.64)0.68 (0.68 to 0.69)0.67 (0.65 to 0.69)0.67 (0.66 to 0.67)
 Non-Hispanic Native American0.78 (0.75 to 0.82)0.68 (0.54 to 0.85)b0.85 (0.81 to 0.88)0.73 (0.58 to 0.92)b0.82 (0.79 to 0.86)0.72 (0.57 to 0.92)b0.80 (0.77 to 0.84)
 Non-Hispanic Asian0.59 (0.58 to 0.61)0.66 (0.62 to 0.7)0.58 (0.56 to 0.60)0.67 (0.64 to 0.71)0.64 (0.62 to 0.66)0.68 (0.64 to 0.72)0.63 (0.61 to 0.65)
 Hispanic0.62 (0.61 to 0.63)0.68 (0.65 to 0.7)0.65 (0.64 to 0.66)0.69 (0.66 to 0.71)0.73 (0.72 to 0.74)0.81 (0.78 to 0.84)0.73 (0.71 to 0.74)
  • Parameter estimates are odds ratios from logistic regression models (with 95% CIs in parentheses). P values versus white <0.001 for all odds ratios. Model 1: no adjustment; model 2: adjustment for age and sex; model 3: model 2 plus adjustment for era, Gini index of county-level income dispersion, rural-urban continuum code, type of kidney disease, years of RRT, mode of dialysis, prior transplant, type of insurance, and dialysis unit characteristics; model 4 (population with Medicare parts A and B): model 3 plus adjustment for number of conditions in the last 28 d of life. HMO, health maintenance organization.

  • a XXX.

  • b XXX.

  • c NS.