ge after the 21st Century Cares Act. We used data from the United States Renal Data System to examine differences in characteristics of dialysis patients and kidney transplant recipients who switched from FFS to Medicare Advantage compared with those who stayed with FFS in 2021, the first year such switching was allowed. We used unadjusted and adjusted logistic regression to compare odds of switching among demographic and geographic subgroups. Among 411,513 patients with FFS coverage in 2020, 10.1% switched to Medicare Advantage in 2021. Switchers constituted 12% of the dialysis population and 5% of the kidney transplant population. In the dialysis population, patients of Black race and Hispanic ethnicity were more likely to switch than patients of White race (adjusted odds ratio [OR], 1.69; 95% confidence interval [CI], 1.64 to 1.73 and OR, 1.42; 95% CI, 1.40 to 1.47; respectively), as were patients with dual eligibility for Medicaid (adjusted OR, 1.12; 95% CI, 1.09 to 1.15). Patients living in the South were also more likely to switch to Medicare Advantage than those living in the West (adjusted OR, 1.48; 95% CI, 1.43 to 1.52). Similar differences were observed among kidney transplant recipients. Patients who switched from FFS to Medicare Advantage were disproportionately from historically marginalized groups, including Black, Hispanic, and low-income individuals. They were also more likely to live in the South. These differences may threaten the generalizability of United States Renal Data System data that relies on FFS insurance claims and suggest that comparisons of outcomes between FFS and medicare advantage beneficiaries with kidney failure should be adjusted for key patient characteristics....

中文翻译：

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比较转为 Medicare Advantage 的 Medicare 按服务收费与 ESKD 受益人与保留传统 Medicare 的受益人


遵循《21 世纪关怀法案》。我们使用美国肾脏数据系统的数据来检查从 FFS 转为 Medicare Advantage 的透析患者和肾移植受者的特征与 2021 年（允许这种转换的第一年）继续使用 FFS 的患者相比的差异。我们使用未调整和调整后的逻辑回归来比较人口统计和地理亚组之间的转换几率。在 2020 年有 FFS 覆盖的 411,513 名患者中，10.1% 于 2021 年转用 Medicare Advantage。转用者占透析人群的 12%，占肾移植人群的 5%。在透析人群中，黑人和西班牙裔患者比白人患者更有可能转换（调整优势比 [OR]，1.69；95% 置信区间 [CI]，1.64 至 1.73，OR，1.42；95%） CI，1.40 至 1.47；具有医疗补助双重资格的患者也是如此（调整后的 OR，1.12；95% CI，1.09 至 1.15）。居住在南方的患者也比居住在西方的患者更有可能转向 Medicare Advantage（调整后 OR，1.48；95% CI，1.43 至 1.52）。在肾移植受者中也观察到类似的差异。从 FFS 转为 Medicare Advantage 的患者不成比例地来自历史上被边缘化的群体，包括黑人、西班牙裔和低收入人群。他们也更有可能生活在南方。这些差异可能会威胁到依赖 FFS 保险索赔的美国肾脏数据系统数据的普遍性，并表明应根据关键患者特征对 FFS 和医疗保险优势受益人肾衰竭的结果进行比较。