odel in 2021, the largest mandatory trial of payment incentives in kidney disease, which randomized 30% of healthcare markets to financial bonuses/penalties to improve kidney transplantation and home dialysis use. This study examines the effect of ETC payment adjustments on US kidney transplant waitlist additions. Methods: Using data from the Organ Procurement and Transplantation Network registry, we examined kidney transplant waitlisting trends between 01/01/2017 and 06/30/2022. Participants were divided into intervention and control arms of the ETC Model. Using an interrupted time series design, we compared slope changes in waitlist additions post-ETC Model implementation (implementation date: 01/01/2021) between the two arms, while accounting for differential changes during the COVID-19 pandemic. Results were stratified by race and ethnicity (White, Black, Hispanic, and other). To examine balance between the two ETC arms, we conducted supplementary analyses using United States Renal Data System and Medicare data. Results: Following implementation of the ETC Model, there were 5,550 waitlist additions in the intervention and 11,332 additions in the control arm (versus 14,023 and 30,610 additions before the ETC Model). Post-ETC, there were no significant differences in kidney transplant waitlist additions between the two arms for the overall cohort (slope difference 6.9 new listings/month, 95% CI: -7.4 to 21.1) or among either White (slope difference 2.6/month, 95% CI -3.0 to 8.1), Black (slope difference 2.2/month, 95% CI: -4.3 to 8.7), or Hispanic (slope difference 0.2/month, 95% CI: -4.5 to 4.9) patients. Conclusions: In the 18 months following implementation, the ETC Model was not associated with significant changes in new kidney transplant waitlist additions. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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终末期肾病治疗选择模型对肾移植候补名单增加的早期影响


ODEL 在 2021 年进行了一次研究，这是肾脏疾病中最大的强制性付费激励试验，该试验将 30% 的医疗保健市场随机分配给财务奖金/处罚，以改善肾移植和家庭透析的使用。本研究考察了 ETC 付款调整对美国肾移植候补名单增加的影响。方法：使用来自器官获取和移植网络登记处的数据，我们检查了 2017 年 1 月 1 日至 2022 年 6 月 30 日之间的肾移植候补名单趋势。参与者被分为 ETC 模型的干预组和对照组。使用间断时间序列设计，我们比较了两组 ETC 模型实施（实施日期：2021 年 1 月 1 日）后候补名单添加的斜率变化，同时考虑了 COVID-19 大流行期间的不同变化。结果按种族和民族 （白人、黑人、西班牙裔和其他） 分层。为了检查两个 ETC 组之间的平衡，我们使用美国肾脏数据系统和医疗保险数据进行了补充分析。结果：实施 ETC 模型后，干预组增加了 5,550 个候补名单，对照组增加了 11,332 个候补名单（相比之下，ETC 模型之前增加了 14,023 个和 30,610 个）。ETC 后，整个队列（斜率差异 6.9 个新列表/月，95% CI：-7.4 至 21.1）或白人（斜率差异 2.6/月，95% CI -3.0 至 8.1）、黑人（斜率差异 2.2/月，95% CI：-4.3 至 8.7）或西班牙裔（斜率差异 0.2/月，100 x 2.2 - 8.7）或西班牙裔（斜率差 0.2/月， 95% CI：-4.5 至 4.9） 患者。结论： 在实施后的 18 个月内，ETC 模型与新增肾移植候补名单的显着变化无关。 美国肾脏病学会版权所有 © 2024...