The Relationship of Provider Organizational Status and Erythropoietin Dosing in End Stage Renal Disease Patients
Bibliographic Data
| ID | 9103767 |
|---|---|
| Authors | Gregory de Lissovoy (Johns Hopkins University, corresponding author), Neil R Powe (0000-0003-2347-3620, Johns Hopkins Medicine, corresponding author), Robert I Griffiths (0000-0002-3341-4547, Johns Hopkins University), Alan J Watson (0000-0001-6763-5535, Johns Hopkins Medicine), Gerald F Anderson (0000-0003-1845-1523, Johns Hopkins University, corresponding author), Gerard F Anderson, Joel Greer (Centers for Medicare and Medicaid Services), Joel W Greer, Robert J Herbert (Johns Hopkins University, corresponding author), Paul W Eggers (Centers for Medicare and Medicaid Services), Roger A Milam (Centers for Medicare and Medicaid Services), Paul K Whelton (0000-0002-2225-383X, Johns Hopkins Medicine) |
| Year | 1994 |
| Volume | 32 |
| Issue | 2 |
| Pages | 130-140 |
| Publication date | 1994-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-199402000-00004 |
| PMID | 8302105 |
| OpenAlex | W2074956604 |
| Language | EN |
| References cited | 6 |
Controversy exists as to whether provider organizational characteristics such as profit status and setting are associated with the content of medical care or efficiency with which care is rendered. Following FDA approval of human recombinant erythropoietin (EPO) for use in clinical practice, Medicare approved coverage for beneficiaries in its end stage renal disease program and established a fixed payment per dose. Because cost of EPO administration varied positively with dose, providers could realize larger profit with prescription of smaller doses. We used Medicare claims data to assess EPO use by renal dialysis providers one year after FDA approval (June 1990) as a function of provider ownership (for-profit, not-for-profit, government agency) and setting (hospital-based, free-standing). Mean dose of EPO was 236 units greater (P = 0.0001) for not-for-profit freestanding facilities, 593 units greater (P = 0.0001) for government facilities, and 555 units greater for not-for-profit hospitals (P = 0.0001) than among for-profit freestanding providers. With fixed payment per dose of EPO, for-profit, freestanding providers prescribed EPO more often and administered smaller doses than not-for-profit or government providers, behavior that is consistent with profit maximization
Business · Dosing · Erythropoietin · Medical prescription · Payment · Dialysis and Renal Disease Management · Finance · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Internal Medicine · Medicine · Nursing
The New Medical-Industrial Complex
Hospital Characteristics and Mortality Rates
Ownership and performance of outpatient substance abuse treatment centers
Patient Selection in the Medicare End-Stage Renal Disease Program
The Ownership of Health Facilities and Clinical Decisionmaking
Managing Physician Incentives in Managed Care
| Citation velocity | historical |
|---|---|
| Highly cited | No |