This is the main directory for data and support files for data visualizations related to Proposition 23 by Team Dialysis Analysis.
last update by: Jessica Mizzi
The purpose of this project is to provide data visualization about Proposition 23, which would invoke new rules for Dialysis Clinics. This GitHub repository contains code for team Dialysis Analysis for the 2020 CA Data Challenge sponsored by UC Davis DataLab and the Scholars Strategy Network. Our goal is to provide data visualizations that will allow voters to make an informed decision about Proposition 23 during the 2020 California election.
Dialysis is a medical procedure where a patient's blood is taken out of their body, cleaned, and put back for patients that are experiencing kidney failture. Patients must receive dialysis three times a week for 3-4 sessions until they receive a new kidney or for the rest of their lives. As of 2020, roughly 80,000 individuals in CA depend on dialysis to survive. Out of the 600 dialysis clinics in California, 75% are owned by the private, for-profit companies DaVita, Inc. and Fresenius Medical Care.
1. Require a Licensed Physician, Physician’s Assistant, or Nurse Practitioner to be on site at clinics during operating hours.
Currently, dialysis clinics are staffed with Patient Care Technicians and a Medical Director. Prop 23 would require a Physician, Physician's Assistant, or Nurse Practitioner to be on site at all times that patients are being treated.
2. Require clinics to report infections to the state.
Dialysis clinics currently report infection data to the federal government. Proponents of Prop 23 say that this would make it easier for patients to find this information, and because this information is already collected, it would not be difficult to also report it to the state. Opponents of Prop 23 say that it is unnecessary to report this information because it is already given to the federal government.
3. Require clinics to get approval before closing.
Although hospitals are required to get approval before closing, dialysis clinics do not. Proponents of this bill say that this requirement will prevent For-Profit clinics from closing clinics that are in remote locations or not profitable, insuring that patients do not lose access to clinics.
4. Prohibits clinics from discrimination against patients based on public or private insurance.
Prop 23 would prevent dialysis clinics from treating patients different based on their insurance type.
Graphic source: CalMatters
Proposition 8 was a dialysis measure on the 2018 ballot. It required that dialysis companies pay back profits over 15% to insurance companies or individuals who pay out of pocket for dialysis services. This ballot measure was defeated, roughly 60% of people voted no compared to the 40% who voted yes. Below is a graph that shows the voting results by countries.
Data source: General Election - Statement of Vote, November 6, 2018 from sos.ca.gov
Both Prop 8 and Prop 23 involve large amounts of campaign contributions. We believe it is important for voters to be aware of what kind of financing is associated with this ballot. Prop 23 is California's second most expensive ballot measure this year, second only the Prop 22. So far, California is the top spender in contributions with $538 million total. The next highest spending state if Illinois, which had $80.6 million, only 15% of that. We encourage voters to reflect on the ballot measure history and financing when they consider which way they want to vote.
Data source: CalMatters Voter Guides 2018 and 2020
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code: contains R code analyses
- CA_Diabetes.R - generates Diabetes Prevalence by Income and Diabetes Prevalence in CA graphs
- CDI.R - generates Chronic Kidney Disease Prevalence and End-Stage Renal Disease and Diabetes graphs
- Dialysis_Profit_vs_Nonprofit_comparison.R - generates Profit vs Non-Profit Five Star Rating Comparison, Profit vs Non-Profit Comparison of Mortality Rate vs # of Dialysis Stations, Profit vs Non-Profit Comparison of Mortality Rates in Relation to Clinic Performance, Profit vs Non-Profit Comparison of Readmission Rates, Profit vs Non-Profit Comparison of Rehospitalizations graphs
- SIR_analysis.R - generates Profit vs Non-Profit Comparison of Standard Infection Ratio graph
- clinic_map.R - generates html map of clinic closing in CA population_map.html
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data: contains datasets small enough to host on GitHub
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images: images for the ReadMe
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output: contains output from code. Each output is linked to the code that produced it in the code directory
Kate Johnson (Team Leader) | Dialysis Overview, Prop Analysis | UC Davis Statistics Undergrad | [email protected]
Hyunsoo Gloria Kim | Prop 8 vs Prop 23 Analysis | UC Davis Microbiology Graduate Group | [email protected]
Haneya Mustafa | Profit vs Non-Profit Quality of Care Analysis | UC Davis & Family and Youth Institute | [email protected]
Earl Morales | Chronic Kidney Disease & Diabetes Analysis | UC Davis Statistics Alumnus | [email protected]
Andrew Caffrey | Dialysis Clinic Map Visualization | UC Davis Food Science Graduate Group | [email protected]
Jessica Mizzi | SIR Analysis, GitHub Construction | UC Davis Microbiology Graduate Group | [email protected]
2018 General Election Results and Proposition 8 Information
- XLS and PDF downloaded from sos.ca.gov: General Election - Statement of Vote, November 6, 2018
- Manually transferred dialysis clinic information from: Ballotpedia - CA Proposition 8
- CalMatters Voter Guides 2018 and 2020
2020 Dialysis Facility Compare Dataset
- Facility details and patient health parameters from Center for Medicare and Medicaid: ESRD QIP National Healthcare Safety - Dialysis Facility Compare
- CSV file downloaded from data.medicare.gov
Mapping California Dialysis Clinics, Populations, and Income Levels
- Dialysis clinic information extracted from the ca.gov specialty care clinic datasets (2012-2019)
- Population and income data acquired through an API call to Census Reporter (2014-2019)
Adults with Diabetes Per 100
- Downloaded from California Open Data Portal as CSV file
- Source dataset for Let's Get Healthy California Diabetes Indicator
- Based on CA Behavioral Risk Factor Surveillance System (BRFSS)
US Chronic Disease Indicators
- Extracted from CDC Division of Population Health using API call
- Focus on CA BRFSS data
- Database containing data from all 50 states plus Washington D.C. & Puerto Rico
- CA SOS Voter Guide - Proposition 23
- CalMatters Election 2020 Guide - Proposition 23
- CalMatters Election 2018 Guide - Proposition 8
- LAO Ballot Analysis - Proposition 23
- YesOnProp23.com
- NoProposition23.com
- California Proposition 23: Dialysis Clinics, Round 2
- Census Reporter Topics
- Living Well / Decreasing Diabetes Prevalence
- Kidney Disease: The Basics
- Thamer, M.; Henderson, S. C.; Ray, N. F.; Rinehart, C. S.; Greer, J. W.; Danovitch, G. M. Unequal Access to Cadaveric Kidney Transplantation in California Based on Insurance Status. Health Serv. Res. 1999, 34 (4), 879–900.
- Tomassilli, J. C. & Morris, J. C.. California Behavioral Risk Factor Surveillance System (BRFSS) SAS Dataset Documentation and Technical Report: 1984-2018. Public Health Survey Research Program, California State University, Sacramento, 2018.