Publication Spotlight: Dr. Lin

Interview with Eugene Lin, MD, MS, Clinical and Resident Fellow, USC Schaeffer Center, and Assistant Professor of Medicine and Health Policy & Management, Keck School of Medicine of USC and the USC Price School of Public Policy, author of Association Between Nephrologist Ownership of Dialysis Facilities and Clinical Outcomes.

What question did your study aim to answer?

We aimed to study the relationship between nephrologist ownership of dialysis facilities and clinical outcomes.

What inspired you to conduct this study?

Policymakers have been interested in whether the conflict of interest stemming from nephrologist ownership of dialysis facilities could negatively affect patient outcomes. Because these relationships are not transparent, we obtained a dataset from CMS via a FOIA request to study this question.

Which USRDS datasets did you use to conduct your study?

We used the enrollment database, the facility survey, the 2728 Form, and Medicare claims.

Using plain language, please summarize your study conclusions in two or three points.

Nephrologist ownership of dialysis facilities was not associated with any negative outcomes. Nephrologist owners had an approximately 2.4 percentage point increase likelihood of prescribing home dialysis at their own facilities relative to other facilities. Nephrologist owners also had a lower likelihood of prescribing erythropoietin-stimulating agents, but ownership was not associated with increased anemia or blood transfusions.

Please share a specific insight about working with USRDS data that you learned during the completion of this study. (No detail is too small.)

The USRDS and especially Medicare claims are a great source of data for granular outcomes. However, it does not include facility ownership data, so we had to separately obtain these data to link the information to the USRDS.