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Open Access Highly Accessed Research article

Agreement of reported vascular access on the medical evidence report and on medicare claims at hemodialysis initiation

Craig A Solid1*, Allan J Collins12, James P Ebben1, Shu-Cheng Chen1, Arman Faravardeh3, Robert N Foley12 and Areef Ishani124

Author Affiliations

1 United States Renal Data System, Minneapolis Medical Research Foundation, 914 South 8th Street, Suite S4.100, Minneapolis, Minnesota 55404, USA

2 Department of Medicine, University of Minnesota, Minneapolis, Minnesota USA

3 Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, Minnesota USA

4 Section of Nephrology, Minneapolis VA Health Care System, Minneapolis, Minnesota USA

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BMC Nephrology 2014, 15:30  doi:10.1186/1471-2369-15-30

Published: 8 February 2014

Abstract

Background

The choice of vascular access type is an important aspect of care for incident hemodialysis patients. However, data from the Centers for Medicare & Medicaid Services (CMS) Medical Evidence Report (form CMS-2728) identifying the first access for incident patients have not previously been validated. Medicare began requiring that vascular access type be reported on claims in July 2010. We aimed to determine the agreement between the reported vascular access at initiation from form CMS-2728 and from Medicare claims.

Methods

This retrospective study used a cohort of 9777 patients who initiated dialysis in the latter half of 2010 and were eligible for Medicare at the start of renal replacement therapy to compare the vascular access type reported on form CMS-2728 with the type reported on Medicare outpatient dialysis claims for the same patients. For each patient, the reported access from each data source was compiled; the percent agreement represented the percent of patients for whom the access was the same. Multivariate logistic analysis was performed to identify characteristics associated with the agreement of reported access.

Results

The two data sources agreed for 94% of patients, with a Kappa statistic of 0.83, indicating an excellent level of agreement. Further, we found no evidence to suggest that agreement was associated with the patient characteristics of age, sex, race, or primary cause of renal failure.

Conclusion

These results suggest that vascular access data as reported on form CMS-2728 are valid and reliable for use in research studies.

Keywords:
Hemodialysis; Medicare; Validation; Vascular access