Study: Home dialysis access decreased during pandemic for patients with disabilities, ESKD
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Key takeaways:
- Before the pandemic, 34.5% of patients with disabilities and end-stage kidney disease transitioned to home hemodialysis.
- About 26% of patients in the post-pandemic cohort transitioned to home hemodialysis.
SAN DIEGO — Access to home dialysis among patients with disabilities with end-stage kidney disease decreased during the COVID-19 pandemic, according to data presented here at ASN Kidney Week.
“COVID-19 exacerbated access challenges across the health care ecosystem, but particularly in underserved communities. Home dialysis is a prime example of this. It is a treatment modality with established benefits, particularly in improving quality of life, but we observed that disadvantaged populations within [end-stage renal disease] ESRD tend to access home dialysis differently,” Emily Belowich, associate principal at Avalere consulting firm, told Healio.
Belowich and colleagues used 100% Medicare fee-for-service claims data to identify 4,427 patients with ESKD. Overall, 2,133 patients started in-center hemodialysis before the COVID-19 pandemic and 2,294 patients started after the COVID-19 pandemic. Both cohorts were on in-center hemodialysis for at least 3 months and transitioned to home peritoneal dialysis within 18 months after the 3 months of in-center hemodialysis.
Researchers found patients who transitioned to home hemodialysis decreased from 34.5% for patients in the pre-pandemic cohort to 25.9% for patients in the post-pandemic cohort (P < .001). Researchers found no statistically significant differences in race, sex, age, dual status or beneficiary state.
Belowich said that patients who have ESKD and disabilities experience greater challenges in activities of daily living, such as transportation and dialyzing at a dialysis facility three to four times a week.
“Our study uses COVID-19 as a spotlight in time to demonstrate that this subpopulation of patients accessed home dialysis less frequently post-pandemic, underscoring the need for access solutions to enhance the utilization of home dialysis among patients with ESRD who are disproportionately affected,” Belowich said.
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William C, et al. Abstract TH-PO1142. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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