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Fewer hospitalizations may help pay for more frequent dialysis

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SAN DIEGO — Fewer hospitalizations with a hemodialysis program in Brazil helped nephrologists offer more frequent dialysis and other services, including free transportation, according to information from a poster presented here during ASN Kidney Week 2018.

Mateus Pascoal, MD, and colleagues from the Centro Brasiliense de Nefrologia & Dialise (CBN&D) in Brazil looked at the costs of treating 176 patients at the clinic after moving them to six-times-per-week short daily dialysis (2 hour-duration treatments). Investigators found hospitalization rates dropped to 2.97 days per patient year, kidney transplantation increased to 7.5% and mortality rate dropped to 7.3%.

“To make this frequent dialysis schedule financially viable, we aimed to reduce the usual high hospitalization rates and costs,” said Pascoal, one of the first authors on the poster, in a press release about the poster. The medical group was able to streamline dialysis delivery, improve patient outcomes and manage resources to achieve an optimal sustainable dialysis practice.

The in-center short-daily hemodialysis program operates five 2-hour shifts per day - a 67% higher productivity without increasing fixed costs, as compared to conventional three 4-hour shifts per day. The average missed treatment rate was 1.47%. The kidney transplantation rate was 4.6% and the mortality rate was 19.9%, according to the release. Daily hemodialysis consumables cost doubled, adding 25% for patient overall costs. Conversely, the hospitalization rate was 75% lower, reducing overall costs by 30% and offsetting the additional supply cost.

“Hospitalization accounts for up 40% of all dialysis patients’ expenditures, leaving no more than 60% for the procedures related to chronic dialysis,” Pascoal said in the release.

“These impressive real-world findings reveal a superior clinical performance of daily dialysis patients, including lower length of hospital stay, higher kidney transplantation rate and low mortality rate - all the desirable outcomes for patients under renal replacement therapy,” said CBN&D Medical Director Juliane Lauar in the release.

“With clinical and economic variables combined, it has been possible to sustain a distinctive yet affordable maintenance hemodialysis program,” the authors wrote.

References:

Pascoal M, et al. The 13-year experience of performing in-center short daily hemodialysis, Poster session. Presented at: ASN Kidney Week 2018; Oct. 23-28, 2018; San Diego.

www.cbndialise.com.br/dialysis-care-redesign-improves-clinical-operational-and-economic-outcomes

Disclosures: The authors report no relevant financial disclosures.