In the Veterans Affairs (VA) population, roughly the same percentage of women and men are Hispanic or missing race and ethnic information, while more women are non-Hispanic black compared with men (15%-27% for women over time v. 10%-16% for men) and correspondingly a greater fraction of men are non-Hispanic whites than women.
Chart Explanation: The chart shows the distribution of race/ethnicity by year, by age, and by year and gender. The y-axis (vertical line) shows the percentage of patients. The x-axis (horizontal line) shows the race groups by either year, age groups, or year and gender.
The VA data presented are from a national sample of health care visits to the VA Health System by eligible U. S. veterans. During any given year, ~ 70% of the outpatient population receives a serum creatinine test. While the demographics of VA Health System users are distinct from the general U.S. population, the VA data allow a ‘snapshot’ of clinical practices across the nation.
National VA data were examined for veterans with at least one outpatient visit during the federal fiscal year. To estimate prevalence of CKD, outpatient serum creatinine laboratory results (averaged if a patient had more than one test during the fiscal year) were used to calculate an estimated glomerular filtration rate (eGFR) for each patient using the CKD-EPI equation, excluding dialysis and transplant patients. Estimated GFR (kidney function) was classified into five CKD categories (eGFR =90, eGFR 60-89, stage 3=eGFR 30-59, stage 4=eGFR 15 to 29, and stage 5 without dialysis=eGFR<15 ml/min/1.73 m² and “eGFR Unmeasured” for those patients without serum creatinine testing. Inpatient serum creatinine data were not used as they would be affected by the presence of acute illnesses. Due to the infrequency of testing, albuminuria was not included in the definition of CKD. Dialysis patients were defined by clinic stop-codes (602-611), outpatient procedure codes for dialysis (CPT4: 90921 and 90925), outpatient diagnosis codes (ICD-9-CM: 585.6, V56, V45.1 and E87.91 and ICD-10-CM: N186, Y841, Z4931, Z4901, Z4902, Z4931, Z4932, and Z4933) to indicate dialysis. Kidney transplant patients were identified by inpatient and outpatient ICD-9-CM diagnosis code V420, 99681, ICD-10 CM diagnosis code T86X, Z4822 and Z940, and inpatient procedure and surgery codes (55.69).
This material is the result of work supported with resources and the use of facilities at the VA Ann Arbor Health Care System, Ann Arbor, Michigan.
|Description of Measure||Race/ethnicity within gender|
|Type of Data Source||Administrative|
|Data Set||VA National Data, using the MedSAS data files|
|Health Care System Data||Yes|
|Regional or National?||National|
|Demographic Group||Patients in VA health plan|
|Numerator||Patients in denominator of each race/ethnicity group |
|Denominator||Patients >20 years old and who had outpatient visit of specified gender (i.e., male or female)|
|Primary Data Source Indicator||Race/Ethnicity|
|Primary Indicator Method of Measurement||Outpatient and inpatient visits|
|Secondary (1) Variable||Gender: Sex|
|Secondary (1) Indicator Method of Measurement||Outpatient visit|
|Frequency of Measurement (Primary)||Multiple measurements per patient|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||2005–2018|
|Analytical Considerations||Race and ethnicity must be examined separately|