Association of Hospitalization and Mortality Among Patients Initiating Dialysis With Hemodialysis Facility Ownership and Acquisitions

Key Points Question Are acquisitions by dialysis facility chains associated with patient health outcomes? Findings In a cohort study using difference-in-differences analyses of US patients initiating hemodialysis from 2001 to 2015, hospitalization days per patient-year and mortality decreased over time in most comparison groups. However, decreases in hospitalizations were significantly slower at acquired vs nonacquired facilities; observed acquisition results were largely associated with changes at independently owned facilities that were acquired by dialysis chains, where acquired facilities had significantly slower decreases in both mortality and hospitalization rates than nonacquired facilities. Meaning Acquisition of independently owned dialysis facilities by dialysis chains suggests slower decreases in mortality and hospitalization rates than would have otherwise occurred.