Hospital costs for patients with CKD may mostly stem from unrelated conditions
Click Here to Manage Email Alerts
Key takeaways:
- Overall, 81.5% of patients were hospitalized at least once during the follow-up period.
- There were 42,283 admissions, which incurred a cost of $231 million AUD.
Hospital burden of patients with chronic kidney disease may mostly be driven by multi-day admissions for non-directly related conditions, recent data show.
“Little is known about hospital admissions in non-dialysis [patients with] chronic kidney disease before death or starting kidney replacement therapy (KRT),” Visal Diwan, PhD, of the faculty of medicine at The University of Queensland, Brisbane, in Australia, and colleagues, wrote.
In the retrospective, observational cohort study, primary outcomes included hospital admissions, analytical approach and the association of demographic and clinical features with hospitalizations, length of stay and cost.
Researchers enrolled 7,201 patients with non-dialysis CKD from 10 public renal clinics in the Chronic Kidney Disease Queensland registry in May 2011, and followed them for 25,496.34 person-years until they either began KRT, died or until June 2018. Person-years accounted for the number of patients in the study and the time each patient spent in the study.
Results showed 81.5% of patients with CKD were admitted at least once during the follow-up period, for a total 42,283 admissions. This incurred a cost of $231 million AUD ($151 million). The average admissions per person-year was 1.7, 10 times higher than the Australian average and twice as high as the national, equaling to $9,060 AUD ($5,926).
Further analysis revealed that single-day admissions accounted for 59.2% of all hospitalization admissions. The leading causes of hospital admissions were neoplasms, largely related to chemotherapy, as well as anemia, CKD-related issues and eye conditions. These admissions constituted 14.8% of the total costs.
Multi-day admissions made up around 41% of all admissions and were responsible for 85.2% of total costs. Primary reasons were cardiovascular conditions, respiratory conditions, CKD-related problems, and injuries, fractures and poisoning, the data showed.
More than 42% of admissions were readmissions within 30 days of discharge, according to the researchers, accounting for 46.8% of the costs. Overall, 90% of admissions and costs were not directly related to CKD, indicating a burden from other comorbidities.
“The hospital burden is very high, reflecting the burden of morbidities in patients [with CKD], the researchers wrote. “One avenue for hospitalization minimization is preventing readmissions for the same diagnosis following complex multi-day hospitalizations.”
Collapse
Read more about
Click Here to Manage Email Alerts