Clinical Outcomes

There are four key measures that are the most common indicators of quality care for dialysis providers. Adherence to these standard measures has been directly linked to 15-20% fewer hospitalizations.

In an effort to better serve all kidney patients, DaVita believes in requiring that all providers measure outcomes in the same way and report them in a timely and accurate basis or be subject to penalty.

On each of these measures, DaVita and our physician partners have demonstrated superior clinical outcomes, which directly translated into 7% reduction in hospitalizations among DaVita patients, the monetary result of which is $210M to $230M in hospitalization savings to the health care system and the American taxpayer.

Adequacy: Kt/V < 1.2

Description:

Measures how well toxins were removed from the patient's blood (the main purpose of dialysis)

Impact of poor performance:

• Increased hospitalizations resulting from toxin build-up
• Increased mortality

Nutrition: Albumin ≥ 4.0g/dl

Description:

Measures the nutritional status of the patient

Impact of poor performance:

• Increased mortality

Fistulas In Use

Description:

The preferred access to deliver the best dialysis treatment

Impact of poor performance:

• Increased infections
• Increased hospitalizations
• Increased mortality

Bone and Mineral Metabolism: CAxP < 55

Description:

Measures the management of metabolic bone disease

Impact of poor performance:

• Increased cardiovascular disease
• Increased mortality

*Other providers defined as the national average less Large Dialysis Organization

Source: Kt/V and Albumin reported in 2007 CPM Report (2006 Data); Fistula data reported in January '09 Fistula First Outcomes Report; Hemoglobin - April 2008 Industry figure; Calcium-phosphate product - average from Plantinga study